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SAN JOAQUIN COUNTY PUBLIC HEALTH SER�CES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> *********************************************************************************************************** <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: The City of Stockton <br /> FACILITY ADDRESS: 428 E. Fremont St . <br /> TANK ID#39- (}51$69q TANK SIZE: 500? PREVIOUS TANK CONTENTS: Diesel Fuel <br /> *********************************************************************************************************** <br /> SECTION 2-To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Jim Thorpe Oil , Inc. <br /> Address: P.O. Box 357 City: Lodi , CA Zip; (5241-0357 <br /> Phone#: ( 209 ) 368-6175 Date Tank Removed: <br /> SECTION 3-To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: Jim Thorpe Oil , Inc. <br /> Address: P.O. Box 357 City: Lodi, CA Zip: 95241-0357 <br /> Phone#: C_209) 368-6175 <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Name: 1 1 Title: Signature: Date <br /> SECTIM4frfgWe agfttecf�t�d2�eu�$* tt*It �e {�e �ff�a i 3�the h tFie�tt* Pale*fig�is�pYt* Yacil t9*Schnitzer <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel n"^dncts <br /> 12000 FlBlvdRancho Cordova, CA 95742 <br /> Folsom . <br /> Address: City: Zip: <br /> Phone#: ( 916) 985-4810 <br /> Date Tank Received: <br /> Name: Title: Signature: Date <br /> EH 23 046 (Revised 08/13/99) Page 10 <br />