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STATE ID <br />PRODUCT to/ occ, <br />SIZE be..st1 SIZE o6) <br />PIPING 5c.\,-koo <br />SIZE to( Goo <br />STATE ID <br />PRODUCT <br />SIZE <br />PIPING' <br />MONITOR <br />STATE I <br />PRODUCT <br /> <br />STATE ID <br /> <br />L PRODUCT' Ut <br /> <br />PIPING socto-i PIPING cuc...itc.. <br />MONITOR LI MONITOR \-1 MONITOR 17/ <br /> <br />tr. <br />UNDERGROUND STORAGE TANK <br />DRESS <br />OPERATOR <br />OWNE R049-2.7777_e_& / 101", eer.... <br />ADDRESS a) gr-G91- <br />BILLING ADDRESS 0. <br />ADDRESS t_ • <br />APN LOT SIZE <br /> <br /> SHORT TERM <br />SANITARY DISTRICT <br />SEPTIC <br /> <br />APCD PERMIT <br /> <br />WATER PURVEYOR <br />FACILITY TYPE <br />TYPE 1 2 3 4 5 TYPE 1 2 <br />TANK # 5 TANK # <br /> <br /> WELL <br />TYPE 1 2 3 4 5 <br />TANK # <br /> <br />3 4 5 TYPE I 2 3 4 5 <br />6 TANK # 7 <br /> <br />DATE 3 - ?3 <br /> PHONE/ *1), - <br />CITY <br />PHONE , <br />PHONE 944 9 <br />91510 <br />CONTACT _EL )2,10-„, qie./c<zMel,42.1 PHONE q c)--- 3 93 c‘ <br />110 4.4 <br />Sheldon R. Heckman <br />President <br />Connell Motor Truck Co., Inc. . _ _ <br />}liver City Petroleum <br />,Valiii~1111~120 <br />scv\--Dn7A (SAM) GRACE <br />Cannock Coordinator <br />PHONE, (916) 371-4960 P.O. BOX 235,84k) DELTA LANE <br />FAX (916) 371-401! wasT SACRAMENTO, CA 95691 <br />ci <br />\ INT 9d 6/86