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FROM BANKS & CO PHONE NO 209 485 3165 Jan 13 1999 09 26AM P2 <br /> i WEST LUAST ,QUIP SALES 1 209 J-61512` -- - --- - ------------ ----------- - -- --- --- ---- <br /> 93_0• � _. <br /> P t'Ji <br /> , <br /> Cr <br /> F4QN[- NCI 2C19 3EG5 <br /> Salt IOaUU1N COUN-rY PUBLIC 1 F,ALTH S.ERYICF3 <br /> ' EN-VfR0N1V zr;rAL HEALTE(P�'ISIDh' <br /> UNDFRGROUND STORAGE TANK DISPOSMON TRACKING P.I'�CURU <br /> 1 � <br /> .!s�ysturM.i �CW.,Ys�MAW00yrs•aa Ytaito tiRK..racilKay.y+Yarri*nrW+�lr Trac.TMaI�sR!'asta..araianr...rax s}•Ata•.sa•�1L Jr+•- <br /> S C'T'€ON I • PubIic i{ealth Services Pav1to=er1W Nvaltl-,DiviaiQn Ta1,tic Tracl ng Sheet&hall a.c=parry caetrh mr,& x1t r <br /> its site tdaadfleariors nusuber 'l-c T=1 T=khg Sheer is to be rcuuned to public Healrh Services En% ronascLtal F3rain,, , <br /> L is V_*W of acaepmwe of the=a k by the disposal Or reeyelEng f=RW The mit holder is:espmr able for esmi nt <br /> suis foxan is compItted and rerumM <br /> FACU-ITY NAME, 41- <br /> I7ACIIY 6.DD55 .., �..�ly 4 .c �_ yGa.� P <br /> ' TANK TD 439 - PRE`'TOUS TANK CONTENTS 4, <br /> f:.arra,YrY rrr�•�ar�.kayr eine ektr r/,tk�sefW■rs�r*s•r.r�rs••w•••Liss*rrA*JAW+atrta��sr aasar*rata:r s.rn r•�.errr4r:.ea..• <br /> SLC-nON I-To be tilled out by tame remorara <br /> l cantct*r <br /> � <br /> 7 aRemoval Contractor cw �,. -- -- - -- <br /> lass- 1. ,,�,,�,r GLAK- _, - -- -City <br /> ' phone/i (rte, . 1_ '�- %3 6 Date T:-nk Removed_ <br /> e <br /> ♦,VW�+Mir�y-rie[W*y1a�r.•Wra ssssrra�M rsa=*,■tit:ss�i,e•isss#W.4a.►r•ii}rka•rt..,ksraa�u�•a efsr....�.,Fx*v+s•s.eN ar L�Rr.-•� <br /> 14ECTION 3 - To be filled out by contmettor)"decotits=i u-i4mg tarifa" <br /> Tank k DeecrLmnisnatioa (.=tractor __- <br /> ' CA 7_Ep 12a <br /> Authorized representative of coauartor cerdfVrnb duoagh 3:gLireuc below that the tank h s been al,3ppr <br /> n,as et as required by Cal EPA. <br /> rf <br /> Nautc. �f�l�f V197i4r7 Title tr ail SEgttatsarr __. Da to. <br /> r , <br /> sa�a:sli.s+,n#swk Y[,Y,kMsf railMY+.ii,►•a_as1ll,iaMri:aT'f�.}flRfsi�lrFRa<alWw4far+kls:Mar.s.ar,►.�F.Nrr«aMse s.sv#.i�T t,.rew�.• <br /> ' S1 C 1Z4N 4-To bo givAed and dzted by an suthvrUt'd representative of tco treerc=, storage or&Total facli.q <br /> IccepLing tank andior ptPulg <br /> F4,nhry Name 14Z d <br /> 1 .aadres5 City zip <br /> Ph one <br /> I I 3=fie i Btl3t lioccivcd <br /> , NFima 1! Title 5�ature � l ���Hate �"-� <br /> { <br /> ', wa+• ttRst+�fr.ssr.as,�wr.a.r+.......r:atir�eax.l:sit=e;lrrlys--I..-a..R-rrr.aa:s,.+R+.a•sMRrr�.rxxi.�sr�._._. <br /> F I <br /> 1 I � r { I { <br /> I11 23 ,'>46 (Revise 7 t0/14/98} V Page 70 1 II <br /> 1 <br /> I I I'V r ' I!1 I t r h I kkI EI II I I I { I II ( { 'II I r 1 �Er lfi <br />