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I <br /> 1 <br /> i <br /> I <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> - ••••••r••Irr•••••••••1••r•♦•rr1•••/••rr•u••••rr•r••r•r••••rr••••••ur••••rrrrrrr•rrrrrrrrrrrrrrrrrrrrrrrr• <br /> 9EC1'IUN t - Public Health Services Tracking Sheet will accompany each lank affixed with Its site Identification number. <br /> 1'he Ttncking Sheet Is to be returned to Public I lealth Services within 30 days of acceptance of the tank by the disposal or <br /> recycling facility. lite permit holder is responsible for ensuring that this form is completed and returned. <br /> FACILITY NAME: <br /> Star Building Systems EPA 11 CAC 001235232 <br /> j 12101 E. Brandt Rd. , Lockeford, CA 95237 <br /> FACILI'T'Y ADDRESS: <br /> i <br /> TANK ID #39 - d Tank Description: 500 gallon waste oil tank <br /> i <br /> Irr••••H••1./rN••H••••••••-0••••••i••••••••r♦r•rH••••••r••/•rrllrrrl rYrlHrHrr rrrrrlrr Mr♦Mr Nr M• <br /> SECTION 2 - To be nlled out by tank removal contractor: <br /> 'Tank Removal Contractor: JIM '1'l1ORPE OIL INC. <br /> Address: 351 N BECKMAN RD / P.O. BOX 357 City: LOW �n oZip: 9 524 1-9357 <br /> Phone #: (20� 368-6175 Date Tank Removed: <br /> •.•.••.•..u1f••u••••••.•f••.••.•••.••.•.••.••.•.•.u••••.•u•••••••1•••••••••••rr•rr•rrrrrrrrrrr•rrrrrrrr <br /> 31'sC'1'ION J - 'I'o he filled on( by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC <br /> Address: P.O. BOX 357 City: I.ODT Zip: g5241-0-157 <br /> i <br /> Phone #: (209 368-6175 <br /> Authorized representative of contractor certifying through signainre belowihat the tank has been decontaminated in an <br /> approved manner as re lied by Cal EPA. <br /> Signa(ure: /�CA � Title: PR&SIDFNT <br /> 1• a •r •♦ r••r.r•• .f•.•♦ ••♦ Nrf• •�•.•Y•••i fJ•N•• ••••HHMH•H•rtr•rrrrrr•rrrrrMHHHr••rrr <br /> �an� f�p1p fn, are firee # ��� slua�es a�td h�dre�c�r�o�1 va�1g� t��o� �g�18FCtYsp6V,,Sjg "jl zer Steel . <br /> SIsC'I' O 4 o e signed and Gate y an nu torize repr sen n ve o the r tWne , o <br /> accepting tank 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 /> Slgnature � ��V 7l� �� - Title: <br /> •.u•1••rIr•••••r••u/••••r•/rr1•••••u•r•1.11•••r1•••••••rr•••frrrrrr••rrrrr•rrrrrrrrlrrrrr•rrrrruru• '. <br /> EN 23 049 (Revised 7-10-92) Page 10 <br />