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UNDERGROUND STORAGE TANK DISPOSIVON TRACKING RECORD •••••4 to•••••••..•••..••••..•.•.•.•••••••••.••••••••••••••.••.••r•.••.••••..••••••••••••••.u••••.••••••••• SFCI'ION I - Public Health Services Tracking Sheet will accompany each tank affixed with Its site Identification number. The Tracking Sheet Is to be returned to Public Ifealth Services within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for ensuring that this form Is completed and returned. FACILITY NAME: Ramsey Real FGtate Dev. FiIhert prnperty EPA Site UCAC 001004008 FACILI-I-Y ADDRESS: 740 N. Filbert St. Stockton, CA 9�(S§ TANK ID N39 - Tank Description: 550 Gallon Diesel/ Gas0lLte Was Le 011 SFUI'ION 2 - 'To be filled out by tank removal contractor: Tank Removal Contraetor: Jim 'Thorpe Oil Inc. DDA Rich-flan Cou^LrucLiou Address: 351 N. Beckman lid./ P.O. Dox 35'1 City: Lodi, CA Zip: 95241-0351 Phone #: (209 ) 462-4581 Date Tank Removed: .•...•.0000.6••.•••.••.•••1•HH••Y•1••1•N••••••1••••••J00J004401•040H•H•NHH••H•U•J•N•J••••H♦•••• SE.CI'ION 3 - 'To be filled out by Contractor 'decontaminating lank': 'Tank Decontamination Contractor. Jim Thorpe Oil,DBA Hich-furl Consl,ructlon Address: 35l N. Beclwtan lid./ P.O. Box 357 City: Lodi, CA Zip: 95241-0351 Phone 8: ( 209) 462-4581 Authorized representative of contractor certifying through signature below that the tank has been decontaminated In an approved manner as required by Cal EPA. Signature: Title: SE.tI ION 4 - To be signed and dated by an authorized representative of the treatment, storage, or disposal facility eccet n 11a�k nd or Ipin lank Is free � II s�u( 9eg anfl hydrocarbon vapors upon delivery to Schnitzer Steel . Facility Name: SchniLzer SLeel ProducLs Address: 12000 Folsom Blvd. CIIy:Hancho Cordova Zip: 95742 Phone N: 9( 16 ) 985-4010 Date Tank Received: Signature: Title: EN 23 049 (Revised 7-10-92) Page 10