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y <br /> 177-.- <br /> SA.`+JOAQr-T`� COL-`TY PLBLIC HEALTH SERVICES <br /> 19 ti�OQ EtiN'IRON•l4E`-TAL HEALTH DMSION <br /> GROL-ND STORkGE TA-SK DISPOSITIOL TRACIU G RECORD <br /> z.z..z.. � <br /> azu.....aa <br /> V\.............zaz...azzz.z.aaa.......a....aaz.a..........................ric s Environmental health Division Tank T.-acking Sneer shall accompany each tank of ted with <br /> SECTION 1-Public Health Se <br /> its site identification number. The Tank Tracidng Sheet is to be resumed to Public 1-ealth Services Eavironmeatal Hex rh Division <br /> within 30 days or acceptance of the tank by the disposal or recycling, Facility. The permit holder is respons:oie for e:surng that <br /> this fora is compieted and ren acd. G1� <br /> FACILI i Y NAME: ) <br /> FACU-rrYADDRESS: <br /> TAn M n 9 - t0 �� Z� T.tidli SIZE: �� PREVIOI:S T_;pis CONTu`-rS: I <br /> --.—szaaaaazaazaaaazaazazazaazzzazazzM.lut <br /> taxazazzazaaaa..................a..aat ..... ............ <br /> SECTION 3-To be tilled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL, INC. <br /> Address: 677 E. Lockeford St. P. 0. Box 357 Mir i midi . LA—Ziu: 95241-0357 <br /> Phone-: (.209 ) 368-6175 Date Tank R,move'-': <br /> zzzzazAAAA..azz...az......a...........aazz.z...z.....................a...a..............................a.. <br /> SECTION 3 -To be tilled out by contractor "decontaminadzi"tank": <br /> Tank Decontamination Contractor: JIM MORPE OIL._ INC. <br /> Address:677 E. Lockeford St. , P. 0. Box 357 City: Lodi . CA Zip: 952x1-0357 <br /> Phone : ( 209 ) 368-6175 <br /> Authorized revmcnta[ive of contractor ce-a rying through sig azure below char the tank has been de ontaminated n as approved . <br /> manner,as required by Cal/EPA. <br /> Name://,/it/��i-I/ �i�JtP� rile: �p�l 7i Signature• /'/ ti� vin Date 19405 4 <br /> .aaaa..a....,... ....za.a a .....a.a...a..a.aa.a:.a ... aaaa.a <br /> >.... ...... ............. <br /> T`an'77c tree or aTT"s ub es anT hadroc rbon vapors utlLon d Iver *� <br /> SECTION 4-To be signed and ddtea by an auhortze� represen nye o e trey eat. s . <br /> ac-.epting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Rancho Cordova , CA <br /> Address: <br /> 12000 Folsom Blvd. Cicv Zio: 957a <br /> ?hone R: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> I Tula: CAIS cm h r�o-o�`c 4' Signature: r' Dzte K "� <br /> Name: /� #q \e S 1 t 1 --p <br /> ..aazaz..........z.z...................... ......a............. ...azz.AAAA.z....a..........=.Y�•••••`••• <br /> ,. <br /> E3?; Cab (Revised 03l 13/99) Pave 10 <br />