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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> EN4TRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed with <br /> its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health Division <br /> within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for ensuring that <br /> this form is completed and returned. <br /> + <br /> FACILITY NAME: �✓qe /T G bJ / 1# ILO�i �i �0� L • <br /> FACILITY ADDRESS: C/AD <br /> TANK ID #39- TANK SIZE: J O� PREVIOUS TANK CONTENTS:At�4C4 gas <br /> SECTION 2-To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL, INC. <br /> Address: 677 E. Lockeford St. P. 0. Box 357 City: I ndi , CA Zip: 95241-0357 <br /> Phone#: (209 ) 368-6175 Date Tank Removed: <br /> SECTION 3-To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC. <br /> Address: 677 E. Lockeford St. , P. 0. Box 357 City: Lodi , CA Zip: 95241-0357 <br /> Phone#: ( 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 /> Name: Title: Signature: Date <br /> T#anT is free o!ra*t sYu* e* ancr h,�drocgbon vapgrs t�Ron det !!ter ;AQP g�aAitrfe1 . <br /> SECTION q-To be signed and d�te by an au hortze represen a ive o e trea [, s r <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#: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> Name: Title: Signature: Date <br /> EH 23 046 (Revised 08/13/99) Page 10 <br />