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UNDERGROUND S'T'ORAGE TANK DISPoS11'ION TRACKING RECORD <br /> ••tit#tt♦•ut#t•r+•t•r•••##rt#tt#rt•tut•#rift•#•utttrt•#••t••t•f•#r••r•••••trr•trt•rrrrr•rrtrtrrrr•r•rrrr <br /> SF.CI'ION t - Public I lealth Services m <br /> Tracking Sheet will accopany each lank affixed with Its site IdenliRralioa number. <br /> the Tracking Sheet Is to be returned to Public Health Services within 30 dnvs of acceptance or the tank by the disposal or <br /> recycling Mciiily. The permit holder Is responsible for ensuring that this form is completed and returned. <br /> FACILITY NAME: Corral Hollow Sanitary Landfill <br /> FACILITY ADDRESS: Corral Hollow Rd. Tracy, CA <br /> �1 <br /> 'TANK ID #39 Description: 1600 gallon diesel fuel <br /> - I / 13"I Tank I <br /> MHf##f!!f♦!ftlf#Hf HftHftl t!•ft#♦f#..lNtHl.HN!#tt#ty•!}ftf#ttt•tt##t#Ht••H tMHt•t!.#.N..A H..M. <br /> SI�C'I'ION 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, Zip: 45241-0357 <br /> 209 ) 368-61'15 Date Tank Removed: <br /> ...........f....ff...f.f..f,f.fff.ff:..fff.ff..f...f.....ff.a.ftfat.a.f•!}ff.�tta..f.a.ftatf t.•t•f t.• <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 _City: LODI ZIP: Wi24j-03r;7 <br /> Phone #: (209 368-6175 <br /> Tank and piping free of all sludges and vapor upon delivery to Schnitzer Steel. <br /> Aulhorizcd feplcscnlalive of contractor cerlirying through signature below that the tank has been decontaminated In an <br /> approved manner as required by Cal EPA. <br /> Signalure: �j _� Title: PR&SIDFNT <br /> .!f!f f fllftirfDfttftQ•r##t..tf• ff ##r •ttgt:ftt•ftft•frit#t•#t•••r•#rrpr•r••rrrur+rrrirrrSrr•hrnrrr•r•r•••-- <br /> SECUION4P "lobe signfree d J fedi by an nullmrlied�repPeseutnliveaos the treatmeftI,,storage,of spoosaf Fa'Cilh}�Zer Steel . <br /> accepting tank and/or piping. <br /> facility Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd City: Rancho Cordova Zip: 95742 <br /> Phone #: ( 916 ) 985-4810 <br /> Date Tank Received: p <br /> Signature: l Title: <br /> Hf.!♦M..........................t.ftt...f.r..tt. #.....fttt##lt............. <br /> .!#!.f l.f r.MMt!!#!!##•#Hilt#1Mr!# <br /> EN 23 ow (Revised 7-10-92) Gage 10 <br />