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SAN JOAgTIN LOCATE F-IE'AL.-r1-WIS-rR3:= <br /> UNDERGROUND TANK DISPOSITION '!RACKING RECORD <br /> ttlFftlttxlxltxlxxtxlxxxxxxlxlx***#xxYtxxlx*t#*!x!lttt!!lYxR*xtxltRR##lxxxxx#*!R!#txx*!txl R! <br /> SWTION 1 - The San Joaquin Local Health District's Tracking Sheet will accompany each tank <br /> affixed with its site identification number. The Tracking Sheet is to be returned to San <br /> Joaquin Local Health District within 30 days of acceptance of the tank by disposal or <br /> recycling facility. The holder of the permit with number noted below is responsible for <br /> ensuring that this fora is completed and returned. <br /> FACILITY NAME: NOR-MAC. TNC. <br /> FACILITY ADDRESS: 6215 Tam O'Shanter, Stockton , CA <br /> TAMC ID 839- /a S� __0 EPA Site # CAC 000180845 <br /> txxltt*#**R!*x*x!x!tltxlx!*!xlxx!!#xx*x*x*x*xxxx**Y!lYxtlxx*#Rt!!t!!!!#*!t*ltttYtlxYxxltYlt <br /> SECTION - 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL, INC. <br /> 351 N. Beckman Road <br /> Address: P. O.Box 357, Lodi , CA zip: 95241-0357 <br /> Phone#: (209) 368-6175 <br /> Telephone: ( ) Date Tank Removed: `7II)-4 <br /> tRRxxY!*RtlY#xx**x*#!*x!*xY#xxxxxxxxxxxxxxxRx*#x**t**xx*x*xxtltYttltx t#tx#txAtttttlxttttt! <br /> SECTION 3 -To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination" Contractor: JIM THORPE OIL / Nor-Cal , Hauler of Rinsate <br /> Address: 807 E. Black Diamond , Lodi , CA 21p: 95240 <br /> Phone#: (209 <br /> Authorized representative of contractor certifies by signing below that the tank has been <br /> decontaminated in an approved manner as may be regulated by Department of Health Services. <br /> . 50 SIGNA7CRE AND TITLE <br /> Yx!!ltYYxtt*tlxxx#lxxxxxtYtxx*x*x*x#lxxYxlxxxxx*xx#!***xYxxxxRxlxxx**x**x*x#x*xx*xxxxxx*!*x <br /> SECTION 4 - To be filled out and signed by an authorized represnetative of the treatment, <br /> storage, or disposal facility accepting tank. <br /> Facility Name <br /> HNITZER STEEL PRODUCTS C:-. <br /> 12000 FOLSOM BLVD. <br /> Address: RANCHO CORDOVA, CA 95747 Zip: <br /> 916-985-4810 Phone#: <br /> Date Tank Received: <br /> AUTHCI[,T79n SIGNATURE AND TITLE <br /> txR**#!xt**xxx*Rxxxxlx!!!!!!RYltYtlxYt!#Yt!*tt!*tYY!!x*!R!lRYxlYRlYt!*Rlxxx!!!YlxxxxxxxlRYY <br /> tH 23 049 12/88 <br /> NAILING INSTRUCTIONS: FQA IN HALF AND STAPLE. AFFIX PROPER POSTAGE. <br /> SAN JOAQl1IN LOCM. HEALTH DISZRICT pp <br /> ATM: UNDERGROUND TAM( PROGRAM <br /> P. O. BOX 2009 <br /> STOCKTON, CA 95202 <br />