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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDFRGROUND STORAGE 'TANK DISPOSITION TRACKING RECORD <br />++#aaa++a+a+aaaa#aaaaf+ff+tail+ai+ffffa+aflarr+r!!!i•ilii+ff+f+ifl4flil+ww!las+!♦!!!ff#If++++##fl++#f###++• <br />SEC'ITON I - Public flealth Services Environmental lieallit Division Tank Tracking Sheet shall accompany each tank affixed <br />with its sire idemification number. the Tank Tracking Sbcet is to be returned to Public Ifeafth Services Environmental Health <br />Divi^.inn 171Udn 30 days of acceptance of dm tank by the disposal or recycling facility. The permit holder Is responsible for <br />insuring that this form is completed and returned. <br />FACILITY NAME:_Ra4h1- *•--h.et F.P.A. 0 CAC (1f10743Rth <br />PAt:fi3fY ADDRESS: 2122 S. Airport Way, Stockton, CA 95206 <br />TANK IU 939 - /06_q TANK SIZE: 12,000 galloMEVIOUS TANK CONTENTS: gasoline <br />.««....«.waaa•. haaaa+awa♦+aa+waaa+♦##asa#aa♦air++lalrf Ra4rrl+r+ff+air++++++++##!ilfiaa+++++++++lff+++f+faaw <br />.4ECTTOM 2 - 10 be filled out by tank removal contractor: <br />Tank Rrntoval Contractor: Jill] '11101'12e Oil, 111c <br />Addtcss:_ 351 N._Beckinan Rd./P.O. Box 35i City: Lodi/r CA zip: 95241-0357 <br />Phone 9: ( 2_O <br />_q_) 368 -6 17 5 Date Tank Removed: Lo 13c) mm <br />♦..aa.«w.Marasalaw+aaaaa+++#aaa+l+l+faf++#♦#!+#a+♦f+lr+i!l++f+f+ff!♦4i!l+wffa++law#++#####+#!+##+#+###++##4 <br />SEC'TTON 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decomnnrination Contractor: Jin] 'Thorpe Oil, 111c. <br />Address: 351 N. Beckman Rd./P.O. Dox 357 City: Lodi, CA <br />Phone 9: ( 209 ) 3611-61 <br />Zip:95241-0357 <br />AntbrniMl tepresentative of contractor certifying through signature below that the tank has been decontaminated In an approved <br />marnter as requirrd by Cal EPA. / <br />Name: /� 1 rx) I f�-F/R Title: !/ JO Sigman re: <br />'Yank' 15 `free'0f d t11 udg'eas"an <br />SFCrl ION 4 - To be signed and dated by an <br />accepting tank and/or piping. <br />Facility Name: Sclu].itzer Steel Products <br />Address <br />phone 1: ( 9 16 <br />12000 Folsom Blvd. <br />Date Fank Received: <br />9B5 -4B 10 <br />Title: <br />♦r++yff ww w+hr+;awa►+++Sw+++ +!#+++# <br />�totag ooicdiaposaffarcilitye, . <br />Rancho Cordova, CA <br />city: Zip: 95742 <br />m <br />«+++++aat+aa++far+♦s+++a+ffffa+f+#fa+!}lfir4af#a!!flf+f+!l+f++#+fr+wlff!!a!!!#+++aw+f+++++++++4#+w+++++w# <br />FII 23 046 (Revised 9/11/96) <br />Page 10 <br />