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�.. ,,.i <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACIMG RECORD <br /> M#ifi#########fi#++fi«##+!«#««!#4a##+4l4lf##«rt#+•«!!+•fi«#rtlfififir+##«#r«!rf#4a!!!l4a4a4a#4fa4a4r4ar4ar44a4/if44ar <br /> SECTION I - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br /> with its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health <br /> Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for <br /> ensuring that this form is completed and returned. <br /> FACILITY NAME: Tri Star Homes, LLC E.P.A. # CAC001166584 <br /> FACILITY ADDRESS: 1325 N. Corral Hallow Rd. , Tracy CA 95376 <br /> TANK ID #39 - TANK SIZE: 800 PREVIOUS TANK CONTENTS: ld gasoline <br /> i###i*###*+nr+.i+i•k++fi•«!#!•««#•+#++fi#«###•#!#rla!!#s4+4!#!rt#4#+##r+4r!!#4firlr«#4#a4aal4M4ar44a4rarrfa►aaa <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Jim Thorpe Oil Inc. <br /> Address: 351 N Beckman Rd./P.O. Box 357 City: Lodi, CA Zip: 9 524 1-0357 <br /> Phone N: ( 209 ) 368-6175 Date Tank Removed: <br /> ***+#**##*++i##+#fi#++!••##!4#fir«+##+:*#*++rtfi••#!«#!«fi+#!#«##Irl+##!!4#####!a#!!!#►a►!!!4!r#ar4arrr444r/aa## <br /> SECTION 3 - To be rifled 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 A: ( 209 ) 368-6175 <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner is required by Cal EPA. <br /> Name: Title: Signature: Date <br /> '1701s'f'ree'o#'aYtsl05e's'an al*y*d'roear6on'va"pars"upp'on"d�efiiver "to cd'hnit r� 'teei'aarr4a <br /> SECTION 4 - To be signed and dated by an aut6otized representative of[tie treatment, sto age, or tspos acil ty <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Rancho Cordova, CA <br /> Address: 12000 Folsom Blvd. City; Zip: 95742 <br /> Phone p: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> Name: Title: Signature: Date <br /> ###+#*#+#++##«++#•++#+fi.r•r+•rt#+!!!+«:#+rtrt+fifi+++!#+«lfir+rt++##++.««++l+4+«ra!!#4r+a+ra#+rasa+arra#++lal+4a <br /> EH 23 046 (Revised 9/11/96) Page 10 <br /> 1 <br />