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l r <br /> q' <br /> FACILITY INFORMATION <br /> Business Name: Kinodon Air Park <br /> Owner/Operator Name: Al Troglian (l�t"� <br /> Street Address: 12145 N. Devri es RnArl <br /> Lodi , Ca <br /> ' Cjty; Zip Cc1JrV.IMR&ATAl HF,AITH <br /> PERMIT/SERVICES J.- <br /> Mailing Address: Same - ' <br /> Phone Number: f ) 209-466-9820 <br /> APPLICANT/CONTRACTOR <br /> Name: Western Meter Service, Inc. <br /> Street Address: 2735 'teepee Drive Suite E <br /> City: Stockto, Ca Zip Code: 95205 <br /> Phone Number: ( 209 ) 948-6124 <br /> Contractor's License Number: 414051 Class C61/D-40 <br /> Certificate of Worker's Compensation Insurance on file with PIIS/EIID? YES NO <br /> �(�y <br /> UST SYSTEM PRINTSET INFORMATION `IJ:. <br /> 1. Four complete sets of plans (To include specification sheets and/or J <br /> equipment brochures if not on file). <br /> 2. Plans drawn to scale in non-erasable print. <br /> 3. Plot plan to show location and number of tanks. <br /> SlyYY <br /> .�i. <br />