Laserfiche WebLink
UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />•u••••••••r•••r•••••••••••••r•••••••••r••••••••u••••••••••••r••••••••••••••••••••r••rrrrrr•rrrrrrr•rrrrr• <br />SECTION I - Public Ilealth Services Tracking Sheet will accompany each lank affixed with Its Site Identification number. <br />The Tracking Sheet is to be returned to Public Ifealth Services within 30 days of acceptance of the lank by the disposal or <br />recycling facility. The permit holder Is responsible for ensuring that this form Is completed and returned. <br />FACILITY NAME: Multi — Day Enterprises EPA # CAC 001256504 <br />FACILrI'Y <br />TANK ID #39 - <br />1444 N_ F1 Dorado St.. Stockton. CA <br />Tank Description: S 00t) <br />1••••r•••••••••••••••••rr•••••r••••r••••••••••••••r••••••••u♦••••r•i••••rur••rrr�rrrr rr•rrrrrrrrrrrrrrrr• <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: JIM THORPE OIL INC. <br />Address: 351 N. BECKMAN RD. / P.O. BOX 357 City: LODI. Zip: 95241-0157 <br />Phone #: ( 209 368-6175 Date Tank Removed: <br />SIP.CI'IoN 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: JIM THORPE OIL INC <br />Address: P.O. BOX 357 City: I.ODT _ Zip: 95241-0157 <br />Phone #: (20g-) 368-6175 <br />Aulhorized representative of contractor certifying through signature below that the lank has been decontaminated In an <br />approved manner as required by Cal EPA - <br />Signature: Title: PRESIDENT <br />i <br />u •. .• •• ••.••••• •.•••• ••• .•.•• •.•••••u•••••••••••••r••••.••••r••rr••rrr•••rrrrrrr•rrrrrrrr•rr• <br />"fan% R pip nc� are Free Q ��� slua�es aNd Udricapo�t va�g� y�o� �1X�CIYs 4a1 �� zer steel. <br />SECT' ON 4 - o e signed and date y an at torize rep sen a re o the r time o , p Y <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel Products <br />Address: 12000 Folsom Blvd. city: Rancho Cordova Zip: 95742 <br />Phone #:( 916 )_ 985-4810 <br />Date 'rank <br />Title: <br />•••••••••••••••••••••••••••r••••••••••••••••••••••••••••••••••••••••••••r•••r•r•r•rrr••rrrrrrrrrrrrrrrr• <br />IN 23 049 (Revised 1-10-92) Page 10 <br />