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Registration #: 197910569
Name: FORMER TARGET
Address: 2309 Euclid Avenue
City: Des Moines
Zip: 50310
Field Office: 5
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Tank:*
--Choose Tank--
Compartment:*
--Choose Tank--
Type:*
--Type--
Renewal
Permanent
Old Renewal
Old Perm.
Temp Closed
Permanent-Small
Old Permanent-Small
Renewal Year:
*
Numeric value only
Val. Date:
*
MM/DD/YYYY
Issue Date:
*
MM/DD/YYYY
Fee Due:
*
Invalid value
Fee Rec'd:
Invalid value
Total Fee :
Invalid value
Tot Fee Rec'd:
Invalid value
Tag No.:*
Comment:
Temporary:
4.1.525.13227
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