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<br /> €ttL 1ANMTWK PROVLEDQ .. 00 TS !OREMS FOR 61WRAL
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<br /> TA59MM. PARSH T:K r+1. 3j Yz..i, PA PR f.,s._c�t tv,_.- AS HEPRE90MG TH=
<br /> ANY24a goverm.z
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<br /> e € € £ 1 Tt: a C
<br /> S t1�} safety, onlyu .t nvt,firL1£r
<br /> kdxb e u_'E .teG€ .nct or r� %4s. the leak,
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<br /> :.'. oloned i rr._e�irt'd€ st r,kti r v ROOMS follow
<br /> hie,iZont%aE aF, tca 1ayear to r„dum rainfall
<br /> KHT16Yjame,.telsoc"a nunbeq and =;i s E:'cr Indicate tr icn ,v c you a.,.�,'S2 a€ ,
<br /> recre-seut oid ,..r�,_r... +,c1*�`pa y sar agency name, . .� iLart$.z n .fit Worrier
<br /> nssi'.:-at vertkal &Me to black },m3b:.onl;_:l ;t.uV£.awP,-t`�.
<br /> o�'�tr,aataiarr,hr¢.,,
<br /> RESP 14y; LE Pray"F v a e 1 E , renrovecontaminsted sc l a dispose aPpr"cx
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<br /> .P::;'ysdzU n ,_r v.,.}, = bc, ck �. rcavr oral We rem c�rUMnate.,t soli ,a d treat inclat.as
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<br /> Ski Y°��ieft,� ,it t,f ,.era !?7,1�i,
<br /> Remove Free Product - remove floating prodwt fmm water
<br /> PTUTTAITAbon yvpKing Us tank fncUilty meati
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<br /> 3.,., q a„�. l•i,.. �arvt'W thefacility ?7.,..Y:_ rx d fall arkir£'4£;,. co'6
<br /> bacteria �_smpr ��.osi of ccntamrirna t,,
<br /> r �ea', £a ar..' 1.,ic,aul Water =, ,,ir Canso!n C:�.<,.� f1pare Supply provide almrnati e waren sea€ply to affectedHaul r 5 Iiar'i,s.. . _-
<br /> ;rea mmi; at "'oils.ip m ¢nst0l weer trcatanent dovi as at enh dwill by or
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<br /> t. E, tr. r._. .. ;n"F .., ',y .amt of ,.nr r,«zn..,u., Y..= E.;. v x 1m", oom s To Acs rn Rcou c ra;,
<br /> incic is Wrr, requiring no
<br /> provinew to for, a_.:er on s "anc _ if af,er-,,-iatr.a H circa than No rememae acti ,r;.m._
<br /> sa s _cca leak sL tts'c Lhc two of mos", oncern fi,r a3caraup� CCMMNTS zs= this 4otW t„ elaborate on ; Y a =etof tiwrlm t.,
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<br /> z r f vIN I kt ` ,-yn the , ..ri ftine space provided.P w a ie-,L, ,a it, £'. " Ga ufrJ t ref cinea.ri of the As'. c t
<br /> If the form is cm,pleted :y the tank ewer or Hs agent, retain ,.o _=ss copy
<br /> W ,n O'urce(s) asf ak. Provide dstails on tank Fa;,, cnpac ty and marl forward the rwa.niny conks in tact to ywr local tank perinAtt ng upma,
<br /> notaHal .� ��nvnr a€�rk � x=e a:e;�afrna coos= �t 1ra >
<br /> =or distribution.
<br /> L 000"! - LmO Tana: Per°ni ts.§tai Agemy
<br /> %f.�t t;lt I State Water Resernrces. Control Board, Nvisitarn of kilter QuaalRy,
<br /> .WOn�t . case typin .t"ory for thris leaks C.smk am box only. Case type mole:=r<,rtaund Tarok FmVm, K 0 Bm IN, Sacraa-aertoq CA NM
<br /> is bawd on the mnr,e s€n0tivc rescues aff, ,.e& For example. if tooth sail ,s. Regional Water Quality Control 8corra
<br /> and ,"and .,at" nava bur 01'sc C case type will ke. `Ground'W?ter". 4. County Board of Supervisms orj sipee to rcr p"e Pr"ositien 6
<br /> Notate D € !�An Cf l i f o '" more .{SEIno % 3 c, > ?"3oti f ica ons.
<br /> .r(� y.}: t Ll-'z`l.,a l- water k,£"E"
<br /> "I" have xta.r ly been Off""? 1 "Nourd Water" r;esrft,.abon d,res naf 5. Owner/responsible party,
<br /> 4.
<br /> r,a, that tho of r_oti m r ca rust on or is nor, used far drinking water,
<br /> Ma c ely t ..t nater wells hoe not ,a t been a;f;: HoL, it iscler>tood tUt
<br /> t, Idgie i,sy change open furthor tnvrtswe,t,orn:,
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