Laserfiche WebLink
y <br /> STATE OF CALIFORNIA A:P ' °O <br /> STATE WATER RESOURCES CONTROL BOARD W , <br /> UNDERGROUND STORAGE TANK PERMIT APPLICATION - FORM B <br /> 0 <br /> •°�teFOM H.�- <br /> COMPLETE A SEPARATE FORM FOR EACH TANK SYSTEM. <br /> MARK ONLY ,❑ 1 NEW PERMIT ❑ 3 RENEWAL PERMIT ❑ 5 CHANGE OF INFORMATION ❑ 7 PERMANENTLY CLOSED ON SITE <br /> ONE ITEM z INTERIM PERMIT ❑ 4 AMENDED PERMIT ❑ 6 TEMPORARY TANK CLOSURE ❑ 8 TANK REMOVED '1 <br /> DBA OR FACILITY NAME WHERE TANK IS INSTALLED: 3� G�""'" <br /> I. TANK DESCRIPTION COMPLETE ALL ITEMS– SPECIFY IF UNKNOWN <br /> A OWNER'S TANK I.D.# B. MANUFACTURED BY: � <br /> C. DATE INSTALLED(MO/DAYNEAR) ; <br />