Laserfiche WebLink
SAN J%,.,ZUIN COUNTY PUBLIC HEALTH SER'.�S <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed with <br /> its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health Division <br /> within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for ensuring that <br /> this form is completed and returned. <br /> FACILITYNAME: Central California Traction Company EPA „ CAC 002106440 <br /> FACILITY ADDRESS: 1645 Cherokee Rd. , Stockton, CA 95205 l <br /> TANK ID Y39 - 153(, / TA`IK SIZE: I�Q00 �ir PREVIOUS TANK CONTENTS: [� l � a o(x) <br /> ii.#x.i....sii.=.#s#ii###=######r##s.###ii###*s#xx}i#}#####irti}*is.=##*=s.=......x## <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Jim Thorpe Oil , Inc. <br /> Address: P.O. Box 357 City: Lodi , CA Zip: 95241-0357 <br /> Phone x: ( 209 ) 368-6175 Date Tank Removed: Q6 cl(o IF <br /> **..i.x..#...i***..i#*i#rt»}*ixi#*}#......#*#.i**iasis}*#**}##}##i.... <br /> # <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: Jim Thorpe Oil , Inc . <br /> Address: P.O. Box 357 Cin,: Lodi , CA Zip; 95241-0357 <br /> Phone A: ( 209 ) 368-6175 <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Name: (yl, �;ty 1►W(Lpe_ Title: Contractor Signaturate I <br /> #��,.,�.,1.yr77x.#7#7*#*#}*z.#=#i.fi#z**fixii#}*i**#*zi#*#..ii.ii#i*.*t**#ziix*.x}i#*#..#i#*}#air#izii <br /> SE[ IZt3R;frgo b�sighed and�atg3eoya n aut orrizoe�reprreesena�tnve of�ieceatment eioXage�ocrdtsposa�efarc lSrteel . <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address:12000 Folsom Blvd. City: Rancho Cordo VD; CA 95742 <br /> Phone #: ( 916) 985-4810 <br /> Date Tank Received: <br /> Name:l(AVt8 h . 1Y�f�}� Title:We y% Signature: Vj Date <br /> ...#....i..z.}..#*i*#***#*x.i##.=x.##.*i#.#..#s.i*i###..i*ii*.*ii*i*#ii*#.*#.}xii#}ii**fi#fi#i.i**##*=i.i** <br /> EH 23 046 (Revised 10/19/98) Page 10 <br />