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w <br />,"W <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />!.!#.l.•!•u!!t!!!!!f•f.l+1,f!!!#t#.f}!f#!!#ff!!fl+f•.•.!•.#fff!#!!.flff#ff#!##ft#####tt#tt#!###+#f#t##ff#t <br />SECTION t - Public I lealth Services Tracking Sheet will accompany each tank affixed with its site Identification number. <br />The Tracking Sheet is to be returned to Public Health Services within 30 days of acceptance of the tank by the disposal or <br />recycling facility. The permit holder Is responsible for ensuring that this form Is completed and returned. <br />rACILI'IY NAME: Teresi <br />FACILITY ADDRESS: 900 1/2 E. Victor Rd Lodi, CA 95240 <br />TANK ID #39 - /-747—Z— Tank Description: 10,000 g^IIM diPCPI <br />!••!••!•••••••t!••••##•••••###••f••!••••••f•s+#+•f•f#}•••f••r,#•••••,!#,!•##tiff•#ftfltrlfft##f#ts•••,••!•• <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor. JIM THORPE OIL INC. <br />Address: 351 N. BECKMAN RD. / P.O. BOX 357 City: LODI, Zip: 95241-0357 <br />Phone #: ( 209 ) 368-6175 Date Tank <br />111#11MIHM}H,1N!#M!♦N,11#!!#!•llMfif•!N••1ff�1•#M•f!###!#M!#fi#!#H#•#ff#fftf#f#♦f##t!♦##t#!#♦tf# <br />SE(:I'lON 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 Zip: 99241-0357 <br />Phone #: 368-6175 <br />368-6175 <br />Anthotixed representative or contractor certifying through signature below that the tank has been decontaminated In an <br />approved manner as required by Cal EPA. <br />�ii11�'9i7�rll� <br />1 f• !♦ !# txttH#t#f, H„H •fx }!Hf#x••it#+}#,111,xHltfH1.1•#♦####N!♦♦#!!##f f1 H!lf t-t##H#####Nf# <br />I pip nr% are free ��� siva�es a�1d hdrgc�rboF va�gr toy �liigilisygal�i$�ttzer Steel. <br />SEC ON 4 - �'v a signed and Sate by an nu mrize rep sen n ve o the rat e o Pg , p Y <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel products <br />Address: <br />Phone #:( 916 <br />Date 'Tank <br />12000 Folsom Blvd. <br />a -IT <br />city: Rancho Cordova Zip: 95742 <br />Title: <br />toff!!1r!!!!!!!!ltllflif#!!R!#R#!x!!.{Ix!{{ftfflff!-ltitxfflf Mff!#N1•Atlfxtf!!ff•xf#,!!#f#!##•••ff f}•#! <br />ER 23 049 (Revised 7-10-92) Page 10 <br />