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SA!S.wOAQUIN COUNTY PUBLIC HEALTH SbMCES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDERGROUND STORAGE TXNK DISPOSITION TRACKING RECORD <br />xxxxxxxxx.ixxxx*x*xxxxxxxx*xx*xxx*xxi*x*xxx*.x**xxx*x**x**xxxx*xx.xxxxxxxxxx*x****xx:xxxxx**xxxx**xx*xxxxxx <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 />FACILITY NAME: Air Port Way Lube Center EPA KCAL 000112867 <br />FACILITY ADDRESS: 442 N. Air Port Way, Stockton, CA 95205 <br />TANK ID.#39 - TANK SIZE: 1000 gal PREVIOUS TANK CONTENTS: Waste Oil <br />ii####*..iii......#######aii##x####.##***#a##ii###############a###i###.##i*i#*i*.......... #ii#i#iia <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: Jim Thorpe Oil, Inc. <br />Address: P.O. Box 357 <br />City: Lodi, CA Zip:_ 95241-0357 <br />Phone Y: ( 209) 368-6175 Date Tank Removed: Q�oZ LCICj <br />* <br />............... ****x..*..rt*xx**#xxi*rtx*...... *..... **... <br />***x**.*.iix.i*.i*....**....i.###x*.#***.x.ii.:*xi <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 <br />Phone k: ( 209 ) 368-6175 <br />City: Lodi, CA <br />Zp: 95241-0357 <br />Authorized representative of contractor certifying th ough signature below that the tattle has been decontaminated in an approved <br />manner as required by Cal EPA. <br />"tame:Title: Contractor <br />Sigttamre�` Date )XII.)—he <br />- t o oe signed and dared by an authorized representative of the treatment, storage, or disposal facility <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel Products <br />Address:12000 Folsom Blvd. City: Rancho Cord Zip; CA 95742 <br />Phone R: ( 916) 9S5-4Ri n <br />Date Tank Received:1UT <br />Name:o'A L 4 Title: ����,/Stgnature- Date i- �Z 7 <br />................ ii#iiiii....... *..iii..#iiiisiiiiiiiiiii.iiiiii.iiiiiii.iiiiiiiiii.iiiiiix*iiiiiii*iiiii: <br />EH 23 046 (Revised 10/19/98) Page 10 <br />