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L SAN x0nt 0C;AL 1S'TRl C T aAtJ i : E1t0UHQ SiOP,A6E 1ky PROGRAM UN - - --- ,. CONTACT TIM .. - - k I rYl51f tE HANE �s/(tic ,�J l I y SIZE PHONE I 41TH /PEA CPGC L STREET ADORE SZ- tLS�I I _3L 'TE � �[� ruDE �# or Td�9 ._�—_•--. _-___•_--- Y CITY U _�•SCl �952��..._I.at Slta _-------_--.......- __..— _..... ...�_ . APPLICANT CONTACT HAltF A APPLICANT/BILL 1116 HAKE I �IL� LG•�LEY F' I ES _. _.._._ `PPLICAHT f'HON uTTK Aa,EA GGPs � 115A[LIr9S AGOP.Ec; ---..-_ _ -• .- A- --1�-,�....'.`.��/�E•....�'�4-•-r-.•.-�-��-�.. •STATE 1 2IF''CODE TYPE oflO4V�r lJ7TAtLhTr�t� my 1G�_�psv _ET4, FACILITY FEE = i i C�),Ail"ea:h 11 A0 DRESS per ':EAR _ -- -_,_._.._......-_ ---. _ ____.___. ---_- - A. ..--•----•-.._:..._._- -._,..-----__-...- __ 1980 � 1987 1388_ _-1989• ��„• T •T�(�U c,n f TAM FEE t50,CO each TAIL}: LT_ 1'3r'(, 1987 1588 1:89S0 CD 'Tan,s Aby fee for -.1_ !- ^ _ t I* each year a��li:able) _ _.. _ ._ - - -- -- - _-.._..__- -- - ■ l -�_-` f••-- 156.00 e«h .aN): (See CA HrALT 1; SAFF-TY CODE Sec 25207 for df DIicabiIity) P, RGE '` _ J l S1ATE SU CNS = -- ( _ ----._..... = - r 1966 T 1957 w1589 1 { Tanis 3 < s56. 0 i �DP Il<'a cxs Y (enter iibI5il a;Jd Year) -f I ` _.-. ---- i-- . - ---. T-■ J'TPERtiAHEI1T-►;1051ikE (Reaovai or Cl•:suru-in-pla':E) _.___..... _. __._. -----•........ *__ __..._..._._...._...- .....__ _ E Tanks _3 x 190,C' _ �.f -I c), _ _-- 0 CLUSURE FEE = 410.00 R40 TANi:�.._ _._..- - -- ---._. •--------• - -- __ --- F TEiiF'CRARY.CLOSliRE (EJnly allowed ori)e• liav for'UD to tva year) IE •-------.•_..__--•---•--•--•-•- --,..______..._..___--__._..------ •----------- ••�: 1 Tdnks T _ z 380.OJ . _._._ l�f...._ � —_ c RY CLOSURE FEE - iSu^UD eac1. iAl(Y, - TEt1r0..i+ " 11EC1; (In,talfation or ?epair) RECEIVED C - - ._.••.- --• - -- F FL's"_._... • -- - n —••- --- -: _ -- _...__ .: .- _ - _ cxf) l /} i . sS1:,sC.Crzac1� S'J6 ISSfttiMAR FLAII CHEU FEE EA _ .__.- K.FAI z -- I iANK REPAIR FE} 5110.00 each TAN1: _.__..... _ � __ -- ---•- —_ I .._...._..:.__^ ..._._: ._... ._.__....,__..._.._:- -- -- .• - -... - --'Y,our to �e paid on. plt-n:: subr;itttaal)_ -- -- _ - - ; PIPING kEPA1x/i:.1C151�rElFE)iJ"Al (Fetes are Per.. - _T ..... a SOPL INN 111SPECT 1 )t y1i l i(NAOe..I._H.._O.R..-I_N_.,D RELEASE EVALUAi101' CO ..__.. .)I.SE�TlO11 ivl:en: •rp.p)i-c--ab- p ,vhen applicable) HE 001 Cr, lea .r. cEE Q0.0011;: I 00 - -_.._..___ ----.._ ----.._•_•-....._... _-.-•_ --- __.... -- OTA(. DUE _ _ —_ .•_ orria USE G.Yty � way r r y 'a d 4` ka �tlld }fit ` tti3hi ► i ' c t��{su'� !`� r�c �"!=x C' C4Eft: !GASH Fr.VO DY DATE P•;CENEO PEDtS1T I ( C �JO f?i0J ,UE S('EEPS Q LOOP t LOC COCE DIST COLE 11I T ..-.:.. _ .._......... �..'.,.. , .. --... .1 I c„_l J:, i 1 II n .•.i;ly 7a• i ,r �S y •�M v, i r• «�y ti"3lv'i �dA .P — — _ r ��P � .n. u,�'�. 1i::;''t'!,”; :r � (I� I .4;�il;ir• 1 .�r'��'A'CI��•u��illhllh{fit:!oltral•1if 1 4 - -- � w •r ru^r i I( is ..,.,. c'1�;fit ^9,9ti 91'a '�'14T.