Laserfiche WebLink
z <br /> f NGTIL,.ATIGN OF HAZARDOUS WAS' DISCHARGE <br /> HEALTH & SAF"ET"Y' CGDE 25280.7 <br /> � �. .w�l � Y�• �sem}��- .. '.� <br />� ���� .�...:.':."'x_"��++r-moi.•4+�- �# �s.� � - .. ii. _ - .. .. <br /> A. F GENCY LEvinE L7 /II m PHS.EH Loci #' <br /> (Circle. Ohe) <br /> B. . P�SOURCE OF W... I ATIGN <br /> C&t. bwvk tr t ek6 s . Si,I **A :rS <br /> ttx <br /> . <br /> &W Sou=e» � ` t ,,«,t .i.PN,s, Telephpone: r 3 .z <br /> ff w <br /> t SDIttx �: 5. <br /> .A.gogcx.. n i�e 1'.c_ripTh <br /> elep on I <br /> r <br /> t :..��,,�dr+�ss» ' `16fl f�','�' ,#c��e 1 �'tr:«e �.1�y�. �C,A 9s"•��: <br /> Cs ;T; LG+ A'TC�N:AI�iD.DATE 'QF DISIARGE ; <br /> r. /yLJJ/•• . ..' / <br /> r flt r.. . <br /> t10J <br /> n»"sc' •J JYI '�� .r+".. <br /> • f �+,• �, ,, a,��I��I rY •Y. n �r !: 'Iin�nYrl I I � r�sYli�'.Y - <br />! r,�,.h*fr 't?.ri�.�t':�y;;.i•7. /l/�{.yy� R�_{ �+I► jy„ wr I /��t' (/ry.'/�y�}y <br /> ��«,;..h Sli'ir n•'� !fi\ �ii D V1.ii LI or,.VIdujaty <br /> 1 f:AY �'�NI1�)x`sfr. 4.lar. 'i•'Q• •..Iy�YyA^S. + . . (City. <br /> i <br /> Y �ilF�l IIY. �YYII <br /> .19�a.}y'Y/:�i±�i�}'/MY���p y��.i.• .]��/�y . j}� .�Y[� <br /> :�4 PL wN?FYYa.t Date i•E/1.1..1.1e d. ' .Y..II�rI��Yb ..X *: Tif�a� l i M ... '�.W` <br /> Di..: RESPONSIBLE PERSON '"WEBS 1 <br /> a s # NAm6 C}fU=ItieSS <br /> Contact person» - Telep ane. .2 --gz7 <br /> t <br /> • /.. Ph i iMYi.Yi7u7. q�.��l�s •. T.11i' <br /> Y �II.IIYI Y <br /> �}/.�Y Y�Y._• T� [/.�)/1{'� t �� Imo. � <br /> ype RClSSC» oft sp lttf S 7 <br /> Volumerrc <br /> Fi- _ACTIGN.TA►It - <br /> r. Ae <br /> EH 22 03 (Rev. 7189 <br />