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t <br /> SAN JUA(ZI1IN eU <br /> IJNI'Y PUBLIC I111ALT11 SERVICES <br /> FNVllmNMEN rAL HEALTH DIVISION <br /> iJNi)f It(;R(llJNi) STORAGE TANK i)15I'0SI•I'I0N TRACKING RECORD <br /> +44+++#f+###4++#####+f4#.k+####►4##+++###+4�«####+#�#++*#4#+f4#########+##+*#A*+MFM#t#***4+MMt*#'+1*#**4**Af*** <br /> RTt:'Ilt)N l i`rihllr. Ilraltb sr-ivlces Enviionnunla! Ilcafill Division Wank Tracking Sheet shall accompany each lank affixed <br /> 4aifh hq gitc itlritl4[ir.rtirrn niimber. Ifie Tank -Tracking Sheel is to be remined to Public liealth Services i±r is respo ts�i Iitalrir <br /> I)lul^irrrl rvllllltr_3o days of aerepllnce of Nie tank by the disposal or recycling facllily. The petmll holder (! responsible for <br /> enstiihIR 11111 Nils rorin is completed and rclulued. <br /> f VILI f'Y N/1NIF' I I McrLot_ Truck Co._, Irrc. _ 1,•l'•fi• �i CAD 9816 <br /> 893 2. <br /> IfAC11,11 Y AlMrZFSs: 2211 N. Wilson Way, Stockton, CA 95205 <br /> diesel fuel <br /> IAMIK If) #.)v — _TANK sum: 10,000 Sal. PREVIOUS TANK CONTENTS. <br /> St t;'I1()r4 1 - To be filled out by rank lei»oval conrractar: <br /> 111ik Reinovll (..ofitractar: Jlgl '1'Ytc.11•�e 011 r_ 111c_� <br /> 0357 <br /> Adtliesq: 35-1_H. Beckman lid./I'.0. Uox 35't' City: I,udi! CA Zip: 952-- -- <br /> I'linnr. A: ( 209 )-_:368_-6 i_l� __ Date Tank Removed: <br /> TIOt4 J - 'I'o be filled ons by contractor ,&.011tarninnifng lank": <br /> 11nk I)et:ontlrnination Contractor:- j1.tn Thorpe Ui-I i.tic. <br /> Addicsq: J5i IJ f 13ec:klltan lld./P-0- BOX 357 City: Lodi, CA Zip:95241-0357 <br /> I'11one A': ( 209 -}_ 368--6 1'(5 <br /> AinhniY7rrl Ir•pirserrtltive of contractor certifying through signatirre below that the tank has been decontaminated in an approved <br /> manner 1q rerinlred by Cal EPA. <br /> Name:_ _ _ _ <br /> Title. Signature: bele <br /> + :�#+ fk+sa ##*++# #a+ + «# ###++## + *# ##+### #####+######++#44## # ♦+R+F#+f***r►►4aa+aa.�ir�aa�liM+M#*#*1 <br /> �ali�C f s reP of a �� 1 u(yeS all( tyr�re�ar )on varr)ors a Imlt Ue� very <br /> SEC I MN I To he- signal and daled by an mill ttor ze representative of if a treatment, sta'fo4ge, or dlspasai raclllty <br /> acrepthig lank and/or piping. <br /> Farillty fllnrr.; West Coast Equipment ---J <br /> f_'If Tui-I ock �� 95381 <br /> lldr11ess: P_(). 13ox236€3 y' <br /> Imte lank <br /> Ff i1nc: f isle: Signature: Dale <br /> Ell 21010 (Revised 9/11196) Page 10 <br /> i <br /> J <br />