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UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION 1 - Public Health Services Tracking Sheet will accompany each lank affixed with Its site Identification number. <br /> lite Tracking Sheet is to be returned to Public Health Services within 30 days or acceptance of the lank by the disposal or <br /> recycling facility. The permit holder is responsible for ensuring that this form Is completed and returned. <br /> FACILITY NAME: Lloyd Guins EPA Site ICAC 000883888 <br /> FACILITY ADDRESS: 303 S. Cherokee Ln Lodi CA 95240 <br /> TANK ID #39 - Tank Description: product Lines Callon Diese Gasoline Waste Oil, <br /> ••••••••••••••••••••••••••••••••••••••••••ur••••r••.•••••r••••••••.•••.•••r••r•r•r•••••r•rr••••rr•rr•rrr•• <br /> SECI•ION 2 - To be filled out by tank removal contractor: <br /> lank Removal Contractor: Jinn Thorpe Oil, line DBA Riot-dart Construction <br /> Address: 351 N. Beckman lid./ 11.0. Box 35"1 City- Lodi, CA Zip: 95241-0357 <br /> Phone #: 20( 9 ) 462-4581 Dale Tank Removed: (41 2�'�7r/ <br /> ••...•.•u••••••••••••...••••u••••.••••••••••••••.•••.r.•••...•..•••r...•••••r.•••••••••••••••••••.••••..• <br /> SECTION 3 - To be Riled out by contractor 'decontaminating lank': <br /> 'lank Decontamination Contractor! Jim Thorpe Oil,DBA Rich-Hari Construction <br /> Address: 351 N. Beckman Rd./ P.O. Box 357 City: Lodi, CA Zip: 95241-0357 <br /> Phone #: 2091 462-4581 <br /> Authorized representative of contractor certifying through signature below that the lank has been decontaminated in an <br /> approved manner as required by Cal EPA. <br /> Signature: C&6 A� A n <br /> SECI ION 4 - To be lsiigned and cdVated by an authorized representative of the treatment,storage, or disposal facility <br /> Tank is free��ilf il�siildgegipa"b hydrocarbon vapors upon delivery to Schnitzer Steel . <br /> facility Name: Schnitzer Steel Products <br /> Address: 12000 Polsout Blvd. Cpy;Rancho Cordova tip: 95742 <br /> Phone #: 9( 16 1 985-4©10 p <br /> Date Tank Received: LA <br /> Signalure: TRIC: <br /> Ea 23 049 (Revised r-10-92) Page 10 <br />