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r)�08 <br /> 3 Y ROUND STORAGE TANK DATE�. �� ti�F: W <br /> ' U- PHOIlE <br /> ADDRESS U( 6 5 , 4 w CITY _ETA 3 <br /> OPE ATOR Fac; 'c PHONE <br /> OWNER CprLCP0 a/1 A P✓V L`asPs &ZPMtV PHONE <br /> ADDRESS A 06 5-- <br /> V v DtL S71CN l !� 9520> <br /> BILLING ADDRESS R O . By 2-a S -[&r C,4+ �Al <br /> CONTACT ��l� h AWP'�"T2_ ��I w►�P.. W. r)�t,�- PHONE [?_Qf <br /> ADDRESS <br /> APN 261-ozo-lo LOT SIZE A-G(z4✓ SHORT TERM APCD PERMIT <br /> WATER PURVEYOR SANITARY DISTRICT /✓ ' <br /> FACILITY TYPE _ e-�,e9s,4 s�L1160- S cSEPTIC 'S WELL <br /> TYPE 1 � 3 4 5 TYPE 1 g)3 4 5 TYPE 1 2 3 4 5 TYPE 1 2 3 , 4 . 5 <br /> TANK # TANK # TANK # 3 TANK # <br /> STATE ID U I STATE ID _ STATE ID —SEDI <br /> E ID <br /> PRODUCT �5 rf U PRODUCT 'zsc C PRODUCT V L c- .� Cj 0 CT U C_ <br /> SIZE 1 UUPV SIZE SIZE (D.�t SIZE <br /> PIP Syu.&HWY% PIPING SyG o n PIPING lSU� o � PIPING C*` <br /> ``• MONITOR Con 'noes' MONITOR Co /'i-raUS MONITOR <br /> Lp <br /> 10 14 <br /> 5� <br /> ` VANDEPOLENTERPRISES,INC. <br /> ` 1001 W Charter Way <br /> Y P.O. Bax 1 107 <br /> Thomas R. Van De Po! <br /> Stockton, CA 95201 <br /> 7� (209) 465-3421 <br /> Outside Area (800) 736-3421 FAX (209)466-191,0 <br /> BEACON <br /> *UST 24 _6/86 ,-�� w;,`:w;•�# t <br />