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SAN JOAQ 11N COUNTY PUDLtC IIEAL'"I SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> a#i#«rwr}i!««r#!!i#►i#a!#►►►#►f«i►lrfi##i►!«!!►}!«!#l►►►►ffi«fflfrlffrfff##f#+#*##+++++++#*+++++++++++++++ <br /> SETA ION I - Public Ilenlih Services Fovhonmcntnl Health Division Tank Tracking Sheet shall accompany each (ink afted <br /> with Its site identification number. 11he Tank Tracking Sheet Is to be reouned to Pubic liealth Services Havironanenlal Health <br /> Dlvislon within 30.dn+s of acreptance of the rnnk by the disposal or recycling facility. The permit bolder is responsible for <br /> ensurhng that this loan Is completed and returned. <br /> FACILITY NAMF:Lincoln Unified Maintainence Yard E.P.A. 0)= CAL 000049384 <br /> FACILITY ADDRESS: 6749 Harrisburt: Place. Stockton. CA 95207 <br /> TANK ID #19 - A—O TANK SIM 10,000 gallOAREVIOUS TANK CONTENTS: diesel fuel <br /> ,rrr•«r•r«r##ir###i}}###r♦}}#!►►lr►}♦#ii}►►►#ia►!!!}►ifff!!#rr♦frflff#rfr#####fr++###*+#+#++�++++++++f1+++# <br /> SE(,I IoN 1 - To be nlled out by rank removal contractor: <br /> Tank Rennoval Contractor: Jlm '1'llurpe. 011, Ittc <br /> Addhess:_ 351 N. Beckman lid./P.0. Dux 357 City: Lodi, CA Zlpg95241-0357 <br /> Phone 1: ( PUq_) 360-61'15 Date Tank Removed: <br /> ...#«r««r##i«!##i##a«####s!!►!♦i#►►lrlflff#♦tl►fr►!♦♦•!fr#r#f4f►fr•rf♦ffr##r#f##*►ff►lrrlf#rff#fro*ffffffff <br /> SEC'T'ION J - To be filled out by contractor "decontaminating lank": <br /> Tank Decotnnminailon Contractor: Jim Thorpe 011, Inc. <br /> Address: 351 N. Beckman Rd./l'.0. Box 357 City: Lorlir CA 7Ip:95241-0357 <br /> phone J: ( 2U9 ) 368-61'75 <br /> Antbonizrd tepreseniatve or contractor certifying turnhgh signature below that the tank has been decontaminated In an approved <br /> wormer ns required by Camel EPA. <br /> Nante: rn g R i N J Rpe Title: V� Signature//Grn7%; �'!�*2K Dete d L 3 l <br /> `lalik`is'r'ree`oi af�'�1}p"aye's'an8al��ayy'd'rroccar'Goii'Sa#pop's"upol" ef�avefrfyyf# <br /> SF,C'I'ION 4 • 1'o he signed and dated by an aulriorro representative of Ilse treatment, stotag , o �l'Rp�oael f lltyee� <br /> accepting tank and/or piping. <br /> rscllhy None: Sclnnitzer Steel Prodticts <br /> 12000 Folsan Blvd. Rancho Cordova, CA <br /> Address: Chy; Zip: 95742 <br /> Phone/: ( 916 ) 985-4810 <br /> Dare lank Received: p <br /> flanne: __Tide: Signature: Dere 2 5 <br /> #!#rMi}♦«##!i►1«;#►f#r►►►}}4►a!i#}!!i1!!►►#}iii}►►#►#4r►►!#!1#4#r##rr#!•f►f♦#f#♦rl►►r►►►►►♦rrflflfff##frf <br /> PII 21 046 (Revised 9/11/96) page 10 <br /> I <br /> t <br />