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J O C T — 2 2 - 9 Y T <br /> ,LOILC C S © S I M D O B B A I M C _ P _ 6 2 <br /> OC7 -- Y :�--`7Y TUE 8 :.1i -J2M DO $Bq <br /> P 62 : Fit <br /> OCT 35 '91 03:02 ERM-t-ESLIW W.C.(415)9-1e-0qC,9C. <br /> ><a rE� <br /> A .xnsaaux;v r.rnrr�r, >x� nr.Trx MYar :CCril <br /> U;DfIiRiMQ TAux DISPG>,9ITION TRACiCINO RDOORD <br /> *t*At*Rlktkf ittk R!##ARRRt}A#t�Rt###tit#ttRA#fRRtR##lXYRttfR!#RRt k#tttfftt#R*RAkA ktA ttat#ktf <br /> lrY;PtC�t{ I " The San Joaquln Local Health DlgtriCtrs Tracking Sheet vill aC.CWpany e,4ch tank <br /> affixed with Its alto identification nwntrr' The Tracking Sheet is to be raturnad to $an <br /> Joaquin Loral Health Dlatxicb vithin JP days of acceptance of the tank by dlapooal or <br /> rncytillrxA facility. The. hold r of � � -1�iStY.�..xY96.R�1�19 �9C <br /> b'ACIC•iTY NAl�;� _ <br /> f•D.CIGIi'Y A01�55- ..•.,•_. . ...,._� _ . <br /> TAW ID 139-., <br /> tkRkRXt Rff Rfktttt#kt Rt Yttttttt�f#t�1tR*#t#XtY%tX►*tXXXRR#Xtk*X#7FR1YtkX kk RXl t**#XRttXtXX#*kk <br /> SI' TIOU " 2 ' To ha J111ed out by tank r4movaI contractor: <br /> Tank Removdi Contractor:,.,, l�l �+� YAP �•_��� 14 L , <br /> Tolsi�honac ( _)M Date Tank Removedl X2 7 1W <br /> kkkkliRXRRtAXiktAtRlt4RRftlAtkR#RA#kk RklNR#AkkXtR#lRktkR1A#Rtt YkRRR####ERR##Eft#R#RRR*R#7Rk <br /> ^40 be f612ad Out by i4ntadCtGr "deCo,7ta itatlml terJcvr <br /> Tonk IbbOntaalrk3ttort" WntraCtOYi C- <br /> �J �. <br /> 1ftA.rcan! .. 'Z„S'3—... .. P4v26c.� <br /> Aathoxtzt�i zegrsaentativa OE wntractor eer es by 61 ping below that the tank has Lean <br /> "e rontolnlrwlod In an a roveg spcaAU ma regulated by DoNtU, ant of Health Services, <br /> AND 71 <br /> '%*t fkRRkkRr,XikAAkR#X#*Xttt##Rtt Ekk kR*kRY AkA#At*##t*AXk#kt#kitkX*RtRt Kkt ARtkRkAktRRklkf <br /> Slz;PiQY 4 - TO b: f1110 out AM signed by en authoristd reprosnetative of Cha treatrsnt, <br /> Storag0, or dispel facllity accepting tank, <br /> Parllity <br /> Acte Tank Recolvedc„- <br /> rte/G(.[, _.,..,.. <br /> - -- - Ty� /►-' <br /> ALMOR1 81R�Aitktk AND 'C[`CLE - <br /> k+kRkkRkktR Rk##Atl AAAI RRtk RkAkk!lt AR *Y tkkf k*k*tk;k*R#ik#ltkitRt#k Rtf RXR*ARt**kR t#kkktRt Rt <br /> Ft1 1J 019 !?/BB, <br /> KA21tNC INSIRUGTIONSs MD IN HATS AHA STAPI,1`i, A117-F1X PROPER "Am. <br /> SAN JWUIN LOC?L W-nTH DISTRICT <br /> A7114s M57 M (JND TANK PROGRAM <br /> P. 0, BOX 2005 <br /> OC7 15 `91 8:08 SRtxxzr• rA 4f?nZ <br /> 191666343'x6 PRGE .00? <br /> DNI NOSA_) Id3 WOb3 F1 01 1F , 61 -„ <br />