Laserfiche WebLink
1%� <br />SAN JOAQUIN COUNTY <br />PUBLIC HEALTH ENVIRO NTAL HEALTH DIVISION VIC <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />fa.ir.a++.r..r.ra•r+r•+arr..fra+♦,rlwafrrlr. r+rr•rarrarwrl:carr+++ra•:rrwaafr#rr#+rfff:ffr#+• <br />vironmental Health Division Tank Tracking Sheet shalt accompany each tank affixed <br />SECTION I - Public Health Services Ennl for <br />ank Tracking Sheet is to be returned to Public Health holer i <br />Services <br />asH Health <br />with its site identification number. The T <br />Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit <br />ensuring that this form is completed and returned. <br />E.P.A. (/ CAC 001381616 <br />FACILITY NAME: Ro—Tile <br />FACILITY ADDRESS: 310 N. Cluff Ave. Lodi CA 95240 <br />2SIZ- 0 TANK ID M39 - <br />I TANK SIZE: 500 eat . PREVIOUS TANK CONTENTS: die al f <br />•..r.i..+ar•..rfrrr.asw.arfrrw+•.rw.rsr.aa.frrtrrwalrarr+•+la.fsrrl•arwwrfra#!!al:arfffr####f+###♦##aH#far <br />SF,CTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: Jim Thorpe Oil Inc. 95241-0357 <br />Address: 3 1 N. Beckman Rd./P.0. Box 357 <br />City: Lodi,_ C A Zip: <br />Phone f: (209 ) 368-6175 Date Tank Removed: <br />...f.f.r......rr+r..r+rr4lr#!r♦a!a#.rwrl+r.awyfw.r.rrra.aura.s#f###!#f1!#!of►flffr♦ff###►###r#!#rffflr#+# <br />SECTION 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: Jim Thorpe Oil, Inc. <br />Address: 351 N. Beckman Rd./P.O. Box 357 City: Lodi, CA _Zip:95241-0357 <br />Phone p: ( 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 />�j � i Title:�Re-S Signature: .� Date <br />Name:_Title: <br />IG%R{l) U � <br />a :. Rata aw+f+ fr wf aw rfss.rf rr af. w! <br />frank 1s #`fee ofi aYfi sludges ani 1lyaroca <br />SECTION 4 - To be signed and dated by an authorized t <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel Products <br />Address: <br />Phone p: ( 916 <br />12000 Folsom Blvd. <br />Date Tank Received: <br />985-4810 <br />Title:f���� <br />Rancho Cordova, CA <br />City: Zip: 95742 <br />.f.r..ii+ f.f.. r.. firs..• rrr r rrrr+w+f#+f.. r r r. s...... a..+...riffrr <br />Ell 23 046 (Revised 9/11/96) Page 10 <br />