Laserfiche WebLink
FACILITY INFORMATION Business Name: 2A I•t0+�- tAAN <br /> Owner/OperatorName• �.1l'�'�awy _ <br /> Street Address: 'u6=,7 E E 1�tA0y1� <br /> City: Oc�c�v C-N 4* Zip Code: 9 S <br /> Mailing Address: SQ.'S S o*�-� CA <br /> Phone Number: (Z01 ) S��-� a3 44 <br /> APPLICANT/ R <br /> Name: <br /> Street Address: y5Z-S 3Q.� <br /> City: 4qvt cv v C7)*% Zip Code: 3Z�� <br /> Phone Number: RZ n) 5s'> — 3_5 4 <br /> Contractor's License Number: t4Aw Class 4/A <br /> Certificate of Worker's Compensation Insurance on file with PHS/EHD? YES NO <br /> UST SYSTEM BLUEPRINT INFORMATION <br /> 1. x. Four complete sets of plans (specification sheets and/or equipment <br /> brochures if not on file). <br /> 2. Plans drawn to scale in non-erasable blue print. <br /> 3. K Plot plan to show location and number of tanks. <br /> 3 <br />