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PUBLI 7 HEAD H SE "CES <br /> SAN JUAQUIN COUNTY .: <br /> e1 . <br /> JOGI KHANNA kI.U.,M.P.H. <br /> IlcahhOflxtt r• , �* <br /> P.O. Dox 21109 • (IWI fast Ilarellon Avenue) • Stockton,011henia 95201 �11MH�� <br /> (209) 460 3400 <br /> UNDERGROUND TANK DIS110511ION l'ItACKING RECORD <br /> •••••••••••..•...••••rrr•r•r••rr••••••r••••••••••rr•••r•rrr••••rr•••r•rr••rrr•rrrrr•.•r••rr•rrrr•rr•rrrru• <br /> SG.(.:I ION I - Public i Tenni Services Tracking Sheet will accompany each lank affixed with Its elle identification number. The <br /> 'clacking Sheel Is to be returned to Public I leaph Services 14111111130 dny4 of acceptance of the lank by the disposal or recycling <br /> facility. 'I he petit holder Is responsible Tor insuring that this foun Is congdeled and returned. <br /> CACILII'Y NAME: INDEPENDENT TRUCKING COMPANY EPA # CAC 000979040 <br /> 17AUILITY ADDRESS: 1145 W. Charter Way, Stockton , CA 95206 <br /> 'IANK ID #39 - 505406- 02 'hank Description: 10,000 gallon Digsel <br /> ...•..••r••••i.••••rrr•••r•••r•.•••••.•••r•••r•••••••.•••r•r•r•••r•rrrrrrr•r•••rr•r•r•rrrrr••a•rrrr•••rrr• <br /> SECI ION 2 - To he filled out by tank removal conlraclor: <br /> lank Removal contractus: JIM 111ORVE OIL, INC. DBA RICII-MART CONSTR. <br /> Mldlcss: 351 N. Beckman Rd. , 11. U. Dox 357 city: Lodi , CA Zip: 95241-0357 <br /> Phone #: ( 209 ) 368-6175 Dale Tank Itemoved: October 4, 1994 <br /> •,••••••••r••r•••r•rr•••r•r•r•r•••••r•rr••••rrrrr•••rr•r•••rrr•rrrrrrrrr•r•rrrrrrrr•..rrr•r...r....•rrr.rr• ' <br /> I <br /> SECIION .1 - to be filled out by clmirnclor "deconlnndnnlhlg lank <br /> -lank Decontamination conhaewt: JIM THORPE OIL, INC. DBA RICII-MART CONSTR./Nor-Cal 011 <br /> Ilau er of r nsate <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 city. Lodi , CA Zip: 95241 -0357 <br /> rhone #: ( 209 ) 368-6175 <br /> Aulhorized representative of conlraclor cerll0ed by slgnhlg below that the tank has been decontaminated In an approved <br /> manner Rs requhed by the Slate Depmlment o Iieallh Services. <br /> Slgonhue: — I-c- Title: Vice-President <br /> JJ f <br /> • •• •• r• r ee •• •r• • •g••s•••• •y••••••• u••••••ro•r•••r••#Vq#tiverr*Lo •Jc`f0 ••zer r•t r• •r••r••• <br /> rank is free of all sl•ua es and'h drocar6on vapors u on a {t S flflS <br /> S130loN 4 - 'ho be slgncd and dated by an nuthurized sepresu{Int(re of the treatment storage, or disposal faclllfy <br /> accepting tank and/or piping. <br /> Faculty Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. City: Rancho Cordo Zip: 95742 <br /> Phone #: ( 916 ) 985-4810 <br /> Dare lank Received: <br /> Slgnauoe: Title: <br /> •.•••••r••..•.•••••••.••••• ••••••• ••.••.•••••••••••••••r•••••r••••••••••••••••rrr•••r•rr••r••rrr•••r••r <br /> Page 10 <br /> ra 23 049 (Rev 2/x/91) up <br /> A biddnn of Stn JmTdn Cnumr Ilttlih Ua 5<nktf <br /> \� <br />