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SAN JOAQUIN COUNTY PUBLIC HEALTH SERWCES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION I - 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 - 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 City: Lodi , CA Zip: 95241-0357 <br /> 209 368-6175 <br /> Phone#: ( ) Date Tank Removed: <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 rinsgd and s . free f 11 sl s io to deli <br /> Authorized representative of contractor certifying through signature below that the tattt}t is beerPcfeconFamtnated-m anXpprtoVvdd <br /> manner as required by Cal EPA. <br /> Name: Martin Thorpe Title: Contractor Signature: Date <br /> SECTION 4 - To be signed and dated by an authorized representative of the treatment, storage, or disposal facility <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#: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> Name: Title: Signature: Date <br /> EH 23 046 (Revised 08/13/99) Page 10 <br />