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FEB 28 2002 3:36PM HP LRSERJET 3200 <br />.11/2007 09:59 209 33 <br />j 2/72/2006 12:49 2 94G^ 130 <br />ENVIRONMENTAL <br />SAN JOA <br />Telcphooe: (209) 4 <br />SECTION I - S1C En•iartmen <br />idmnficavaa minter. lira TW <br />:ccryrince of the tarsk by the di <br />cormlrted cnd remmed. <br />FACILITY\AivfE; ;— i( <br />FACILITY ADDRESS: ZG Li <br />TANK 11)939,0,51 i81C <br />SECTION I • To be filled out by t <br />TVA Rcmoval Ccvtactoc'c7, <br />P.`,onc rr• (_ pct- �� <br />SECTION 3. To be filled out by <br />'Ink Dcaonrarrdnoiion COnbacb <br />Avtnariud ropnzenhtive of eonva <br />meaner 41 rcquired by Cal FRA. <br />..... 1 ................Y...... <br />SECTION 4 . To be .igacd and dat <br />L !o!50011 'tank and/or pi <br />Fa.tl ryl:ame:� <br />Dau Tm�cd: 111. <br />... <br />EH 23 046 (Reviled 11/21/96) <br />d Health Depanment'1 Tar <br />Tracking Sheer is to be rc <br />Doul or «cycling facility. <br />EHD <br />• <br />ENVIRONMENTAL <br />HFALIH <br />p.4 <br />PAGE 12 <br />PAGE Wll <br />.EALTH DEPARTMENT <br />AN COUNTY <br />420 Fax: (209) 469.3433 <br />;.DISPOSITION TRACKING RYCORD <br />.YIYY.Yar.. Y.... *..4 .................. H.N... <br />Tracking Sheet sball "company each tank ■ffxed wish iu site <br />Ned to the Environmcntal Health OcpwuwrIt within 30 davr of <br />'he permit.hwlder is rasponsible for enzvrlag thee this form is <br />OCSlZE:S��ER PREVIOUS TANK CONTENTS: :ter <br />..........nnro..• r.r.Y\.nr...u..r.rY.q.....\......................... <br />removal contractor; <br />ter- <br />CifYS Q CT6 <br />_Date Tank .Re ved; _I—Z6;—d2 <br />..ur.. n... Y...........o...u.............................. 1............. <br />City.. C.k, 6'� Zip:qszoj— <br />cemVyiag through siEnaru o bclow Nt 119-1111.1lika6cil decorssaminated in an app.toved <br />.f...I.Y.f YYYf.•rfi... .YI\\.a...............Y.Yf.YY. Y.f YV Y.f. rff... Y....... <br />by ah 4mhorimd reprcaen ative of the hearment, smrego, nt disposal facility <br />I <br />I... r ....I... Q.... <br />a... NUN.\bH HH.............. I..•.. <br />