|
UNDERGROUND STORAGE TANK DISPOSMON TRACKING RECORD
<br />•,r,.pt,sur.pt•.ttq,tft•s.,.,rrta.►.,.t•p,t•t.a►.st•..,.t•..►,tp►as.rtar,r•tr.,rr.t.r>.,•,.••.,..,.•r.
<br />RW -MON I - Public Health Serer Tracking Sheet will accompaay each tank aitmad with Its site identlBatloa number.
<br />71he Trucking Shea is to be returned to Public Health Services stthy 30 fens ad
<br />iOC7 g Tho resit border is tapomiMe for eatu rteg that chic corm Is ong4etcccPt&ecx o[ the tent by the 44pon1 a
<br />oonpfetnd and returned.
<br />FACILITY NAME: CAL-LOAST TANK
<br />FACUMT ADDRESS; 424 J- TEGNER ROAD, TURLOCK, UA 95381
<br />TANK ID AT39 - J 66 � —t? �- Tank Daecri,,".
<br />.t►tt,,,.r,f,rrf,ft•trrt,t..tft•ft...f•........................ t..rat>.t.,.It�a..r.1.,.•p.R..L..•
<br />SECTION 3 - To be illied out by tank rqqxmi contractor:
<br />'chat Removal Contactor. JAMES J. HOBI TT7FI I
<br />Address: Eox 30331 STOCKTON 95[13
<br />try_ Ztp:
<br />Phone #-2( 09 ) 943 7793 Dam Tent Remoree:
<br />............. t..,......................,..........
<br />SEMON 3 - To be filaed out by contractor -dewetaminatfng truck.:
<br />Tank Decontamination Coetacworc .IAMF.S .1. H(1RI TT7FI I
<br />,�,,,,,: Box 30331
<br />Ybom *: i 20% 943 /795
<br />ate STOCKTON 95,213
<br />P
<br />Autboruxd to rmentative of contactor certifying through stgstature below that the tank has been decontaminated in an
<br />approved Ranter at required by Cal EPA. 4
<br />9.1.
<br />t.......
<br />Titin �i�u-k-v-c
<br />rH,tHg4Nrt ♦f.,,.a..• •,ttH. H t>./tit Utt r.ff u•u
<br />SEM014 < - To be signed and dated by an authorized tepreseaLHve or the treatment, storage, or disposal facility
<br />accepting tank aadjor Piphit
<br />Facility Names CAL -COAST TANK
<br />Address: 424 �. TEGNER
<br />Phone o: r L09 1 668
<br />Tate Tank
<br />ttrt►ts*
<br />Ea 23 049 (ftVIWA -10.W) PON fly
<br />city• TURLOCK
<br />7W=
<br />95381
<br />....,rttr, t,t..•, a.ttt,►,.rrtprtatq...,.
<br />
|