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I ' <br /> I <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION L - Public f{ealth Services Tracking Sheet will accompany each Tank affixed with Its site Identification number. <br /> The TrRcking Sheet is to be returned to Public health Services within 30 111113 of acceptance of the hank by the disposal or <br /> pleted end returned. <br /> recycling facility. The permit holder Is responsible for ensuring that [Ills form Is com <br /> FACILITY NAME: <br /> Star Building Systems EPA 11 CAC 001235232 <br /> FACILITY ADDRESS: 12101 E. Brandt Rd. , Lockeford, CA 95237 <br /> TANK ID #39 - Tank Description: 500 gallon waste oil tank <br /> i <br /> •••u♦•••••••••••••••♦•r••••••••••••••••••••••u•••••••r♦•••••♦•••♦r•••r•♦••••r••r•••rrr•r•r•t••tNr••••rr• <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> 'Tank Re111UVRl Contractor: JIM T110RPE OIL INC. <br /> Address: 351 N BECKMAN RD / P.O. BOX 357 City: LOW Zip: 95241_9357 <br /> Phone #: (209 ) 368-6175 Date Tank Removed: <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tnnk Decontamination Contractor: JIM THORPE OIL INC <br /> Address: P.O. BOX 357 City: LODT Zip: q5243-0-197 <br /> Phone #: (20 368-6175 <br /> Aulhorized reptesentative of contractor certifying through signature below that the tank has been decontaminated In an <br /> approved manner as required by Cal EPA. <br /> Signature: Title: PRESIDENT <br /> . r•��..�•• ••{{•qq••..••• ..•••�•t••ai ••..• ♦�.••••.••..••••.•••••••rr.r••••••r•r....l.,,r1••.•••..irrrrG.�.hr.{..rr.•..• <br /> SITION 4;P"1'o be sign freeITdated by nnlnatlrorize�ieliiaei9n�ve o�theaPg�t�Sne���otUgBi���spU�al luCl�(y�zer Steel . <br /> accepting lank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address, 12000 Folsom Blvd. city: Rancho Cordova Zip: 95742 <br /> phone #: 9( 16 ) 985-4810 <br /> Date Tank Received: <br /> Signature: Title: <br /> ••••.••••••r•••..••••••.••••••••••••.•••••••••••••••••••••rr••u•r•ur••••rrr••rrr••••••r.•••••r•r•r•r�• <br /> ER tl 049 (Revised 7-10-92) Page 10 <br />