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SAN kQUIN COUNTY PUBLIC HEALTH SEP- CES <br />ENVIRONMENTAL HEALTH DIVISION -- <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />w*WrrtwWWra+rWrtw+.#rtrrrarr+rrr+rrrrrt*rtrW+wit+Wrt+rrw+Wrt►++r#rrrtrtrrr+rwwWrtrrtarrr#rrrtrrtwWrWrsr.rwW►rrrr►rtrWrtr►►+ <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. <br />FACILITY NAME: Gateway Project <br />FACILITY ADDRESS: Block bounded by Lafayette E1 Dorado Center and Sonora Street <br />TANK ID x39 - TANK SIZE: 1.000 gal. PREVIOUS TANK CONTENTS: Unknown <br />Writ#WWrWWa**WrtaaWW WWrrrwrrtrtrtr W#rrrrWWrrrrr+WW WrrrWaWWWWWrRW*rtWW*Wart W#W*#rrtWWrWrt*rWW#W WrssrrrrtrWWrrrtWr*WWrrrt <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: Evans Brothers Inc <br />Address: 7589 National Drive City: Livermore Zip: 94550 <br />Phone p: ( 975 ) 441-0225 Date Tank Removed: <br />w+####W Waaartrtas#r++rtrtrrrrrWrrrrr#ar*rrtrwrt*##++rta++a###Wrrrrrw*##art+#+#+###rrrtrr+r*r+raa#+r#*rtraW##*+####+rrt <br />SECTION 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: Fvnnc Brothers Inc <br />Address: 7589 National Drive <br />phone p: ( 925 ) 443-0225 <br />City: Livermore Zip: <br />94550 <br />Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br />manner as required by Cal EPA. <br />Name: <br />Title: <br />Date <br />aart*rtrtWrrr*+W#W#rt+rt*rrrrrrt+*rrrr+rr+rrtrrtr*W+Wr#WWWW#rrt+#r#rtrtr*r#*a*rr***rrartrrrtrtrrtrrt#r##+rWi*rWWrrrtrrrtrW*WW <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 <br />Address: 1101 Embarcadero West City: <br />Phone k: ( 800 ) 449-3919 <br />Date Tank <br />Name: <br />Oakland <br />Zip: <br />94604 <br />Tide: Signature: Daze <br />rtrtr*rrrtrrr+*rWsrtrt W**w+rr*WrtraWr+wrrrtW+rrarrtrarrtw+rrrtrr+*rtrrWrt*rWrtrtrt#rtrtrtaiarrrrWWWrrtrWWrrrr+WW+rrrrrtrr*4rtr <br />EH 23 046 (Revised 10119198) Page 10 <br />