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v ` SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONNIENTAL 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. EPA # CAC002550730 <br /> FACILITY NAME: The City of Stockton, <br /> FACILITY ADDRESS: 310 S. American St . Stockton, CA 95203 <br /> TANK ID#39 -OQs 653 TANK SIZE: 500gal PREVIOUS TANK CONTENTS: Diesel Fuel <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 Cin,, Lodi, CA Zip: 95241-0357 <br /> 209 368-6175 <br /> Phone #: ( ) Date Tank Removed: cz 0 Z. <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, CA Zip:95241-0357 <br /> Phone#: ( 209 ) 368-6175 <br /> Tank has been rinsed and is , free off 11 s t ebs for to drlelanvpeprr <br /> Authorized representative of contractor certifying rough signature be ow tat the t s ee econtammate m a ed <br /> manner as required by Cal EPA. <br /> Name: Martin Thorpe Title: Contractor Signatur . I Date L <br /> Tank t **d df *a7Ts tl"dge5 att hVdrTcarbRn vaRors .ueop delliverb �g S�h�1i�� r �S�g�1 <br /> SECTION 4- To be signed and dated by aiS aut orize repr entatry o the reatme s rag , r I �osa t t <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> 12000 Folsom BlvdRancho Cordova, CA 95742 <br /> . <br /> Address: City: Zip' <br /> Phone#: ( 816 ) 985-4810 <br /> Dace Tank Received: U <br /> _r <br /> Name. CV Title: Signature: DateV <br /> #**###**###**#**##**###*###*####*#*##**##***###########*##########**###*###****####**###**#####*##*##*#*# <br /> EH 23 046 (Revised 08/13/99) Page 10 <br />