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------------- ------ ------ - ------- -- - ---- ------ - --- - - - - -- --------- ------- --- - <br /> 02/08/1994 04:14 2095i-,909' VALLEY ENVIRONMENTAL FADE ba <br /> UNDERGROUND STORAGE TANY DISPOSPTiON TRACKING RECORD <br /> rrHbbblrb raiaaaabat•Hlrr grlH bre uiiHNaH aH rraaAtHbrrrib!rblHrigbrHi•rirM Y W YHlr♦,r. <br /> SECTIOiv 1 - Public Health ServiM T14"S Sheer will accompany each tank atm(nd with its site tdeatillcatoa number. <br /> The Tracking Shat is to be returned to P6)Ic Health Stn 4cea wD $of acceptance of the tank by the disposal p� <br /> ;r�ag'pcih Y .4the rwrPfA b'jWar is trsponsible for ebaarWg ttaazbl. form,is c - tnx. �:,4 resumW. <br /> FACII.ITf NAME—Cal Coast Mfg. <br /> FACIL.ITYADDRESS• P.O. Box 1964, Turlock, CA 95301 <br /> TANK ID M39- 1 D 6 5 Tank Description: <br /> Hlp4OsrlraY stbHHbu Hsbrlrltsr Ysrtrrtrab!!Nlra HfblarrrHbrrlrrsaarrriH H.YH H..H —_— <br /> I.HMMa.. <br /> SECTION 2 -To be mied outM mWvW Maton <br /> Tank Removal Contractor. �11eY ractEnvironmental Solutions <br /> Address: P.O. Box 48 syn Stockton Tip: 95201 <br /> Phone : 2( 09 S47-9000- -- Data <br /> Tactic Retnouad <br /> tH HlrlttlYtHHbrrlsrHM Bari bre Her HrYrlbrrrrlH bblaa tb ..............r brii!lr.......... <br /> SECTION 3 - To be dUed out by contactor r4ecoatamlaatng tank': <br /> Tank Decontamination Contractor Valley Environmental Solutions <br /> Addrear_ P.O. Box 48 CIty: Stockton Ziv:95201 <br /> Phone : L 209 ) 547-9000 <br /> Aathorind represeatativo of contractor mrtUying through sigbatmc below that the tank has been decontaminate4 in an <br /> apprtmd manner as required by Cal EPA <br /> Stgaature: ; <br /> •rrIHHH'leery Hrrrlrrrr1YH 11 Y riMitY\...rrtY.rYMI Htt YligrYYrYir Nrl rf lrlsl Y.Mi..YrY1YYY11111Y.iHHH! <br /> CiION b -TO br<ISMA and dated by as anthorlaod representative of the treatment,storage, or disposal facility <br /> FkdUtyNaW: Cal GOa9t !Ifr,. <br /> A4drm., P.O. Box 1864 City Turlock Ztp: 95381 <br /> Phone #7 ( 209 1 668-9378 <br /> Date Tank Received: <br /> i <br /> Signature <br /> r E...i.....NHHl...... 9H Dar....... s •..rHrrrl rrlH......Hrrr-Y blH a!"ro a-a rbllrub........... <br /> FH 23 049 (aYntaad 7-10-92) ease 10 <br />