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' �,� .1oA�=rt r,oc2�r, r�>Ii:xt-.z't�� smFticr <br /> LjNDERGRoLjND TANK DISPOSITION TRACKING REODRD <br /> fAARARAAAAtfAtltRfA tAAtRfAARtAARAtAR1tRAlAR 1RtRltltRttARtRARABheatlVSl lAaocfompany eachA tank <br /> SWrION 1 _ The San Joaquin Local Health District's Tracking <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 ofn the tank by disposal salh r for <br /> recycling facility. The holder of the Decalt._Jl �- <br /> .., rMt this forlLla ronileted and returned — <br /> FACILITY NAHEt Babka Distributing <br /> FACILITY ADDRESS: 1245 W. Weber Avenue,_Stockton C Oc 5 j�6 y <br /> 139-ID Z000 - b Z 1 - 3,000 gallon Diesel fuel tank EPA Site ii <br /> TANK RR ID 139- ARf AtAAAf RtRttA tRARA#t1tRRA#RAtAA##RRRAARf#tRtARtRARRttAAf AAAAAAAftR 6204*4Atf <br /> BOCPION - 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OlLt INC. <br /> 351 N. Beckman Road, Lodi , CA 95240 Zip: <br /> Address: phonal, 12 368-6175 <br /> Telephone, ( 1 Date Tank Removed- <br /> Telephone: <br /> RtARARRCAAAt1RAfR#RAAARAARt#ARAARt#AAAtRARAAAtAA rR*twAARARARAtAfAlAtlAAAAAAAlAlA <br /> nati <br /> B®CIICN 3 -To be tll1; out by contractor MrTHORPE OtIL1 NC./ Nor-Cal Oil , Ilauler of rinsate <br /> Tank Decontamination"' Contractors <br /> 351 N. Beckman Road , Lodi , CA Zlpi 95240 <br /> Address PhoneII 1209 368-6175 <br /> tractor certifies slgning�l�tmehtof Health Serviced- <br /> decontaminated <br /> tthe tank has e <br /> Authorized representative of cona. <br /> decontaminated in an approved manner as may be regulated by pa <br /> Vice-President <br /> j SIGNATLRE AND TITLE <br /> #RAAAAAAtRRRRRRARtRtRRRRRARtARRtRRtttRAARtARRARRAARRARRRttfRRRfRtfARAttRf RfftAtRtRtttAAtAAA <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 /> Address: SCNNFTZER STEEL PRODUCTS CO ZIP- <br /> 4310 <br /> Phone!- <br /> 916-985- , / /L (7 / <br /> i "1 <br /> Date Tank Received: <br /> AUTHOR I Z S I ONAT,iRE AND TITLE <br /> IRRAf!#ARRRARRRRlRAl RtRARflRARARAttR#RIARRRAAAtftARRARAARARRfRAAAAAAAAARtf AAfAAAAAtAAAlAliR <br /> eN 23 049 1288 <br /> HAILING INSTRUCTIONS: FOLD IN HALF AND STAPLE. AFFIX PROPER POSTAGE. <br /> SAN JOAUUIN LOCAL HEALTH DISTRICT <br /> AnN: INDERGROOND TANK PROGRAH <br /> p. O. BOX 2009 <br /> STOCK", CA 95202 <br />