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SAN JOAQVIN LOCnr• FIMA r.rH 0I <br />9P <br />UNDERGROUND TANK DISPOSITION TRACKING RECORD <br />RR**RlRRR*!!A!lRRt*RRRRR*ARA***#**RR**R**ARA***A*A*R*RAR!!R!lRRRRlR*l �RRQArR �R'RRlRlRRRRR <br />^CION 1 - The San Joaquin Local Health District's Tracking Sheet will accompany each tank <br />fixed with its site Identification number. The Tracking Sheet is t?,,;ON DedAHb San <br />3quln Local Health District within 30 days of acceptance of the tank W,14066A Fbr <br />:ycling facility. The holder of the permit with number noted below is responsible for <br />NAM: STEVES RENTAL <br />ILITY ADDREss:_ 275 E. GRANT LINE ROAD TRACY, CA. 95376 <br />K ID 139- y 3S - <br />R**RRRRtARRfi R!****R***R****Rt****R******AA*ARAAAAR***R*RR******************************* <br />TION - 2 - To be filled out by tank removal contractor: <br />Removal Contractor:(TECC) THE ENVIRONVENTAL CONSTRUCTION COPPANY <br />259 KIND DRIVE SAN JOSE, CA. zl : 95112-4433 <br />Phonel:008T <br />lephone: ( 408 1 997-1505 Date Tank Removed: <br />A*RR*RBBB#RR**A*RRA****R*R**RR*********AR*RAARRRRR*RAlRlRAR*RRARARR**ARARAAlR*RRRRAARRR*! <br />'TION 3 -To be filled out by contractor "decontaminating tank": <br />Decontamination" Contractor: H&H SHIP SERVICE <br />_zip,94107 <br />1(415) 543 -URS; <br />lzed representative of contractor certifies by signing below that the tank has been <br />aminated In an approved manner as may be regulated by Department of Health Services. <br />SIGNATURE AND TITLE <br />RRR*RRA*RRR***Rfi**RBBB**RR*RRR***Rfi R**RR*RR*RRR**RR***RA*R**RR*RRR*RR**RRR*RRR*AAAlR <br />4 - To be filled out and signed by an authorized represnetative of the treatment, <br />or disposal facility accepting tank. <br />Name H&H SHIP SERVICE <br />SAN FRANCISCO, * CA. <br />Tank Recelved: <br />zips 94107 <br />•(415) 543-4835 <br />AUTHORIZED SIGdATURE AND TITLE <br />A!*lRfRRARRRlRRRRlRR!##RRA##RR!#AAARA#AR**R*AAlA#AR*RR*A*lARRlRRRRRRAAlARA!*R!!RlRRRRAR*A <br />23 0/9.12181 <br />ILING INSTRUCTIONS: FOLD IN HALF AND STAPLE. AFFIX PROPER POSTAGE. <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />ATTN., UNDERGROUND TANK PROGRAM <br />P. 0. BOX 2009 <br />STOCKTJN, CA 95202 <br />