Laserfiche WebLink
ENVIRONMENTAL HEALTH DEPARTMENT <br /> AN JOA QUIN COUNTY <br /> T,alephone: (209) 46$-3420 Fear: (209) 468-M33 <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> •�.r...rr waw M rt r�ww tM.r►r�w�«Kv,►„wtk•�r,r,w+.»w r.r•w+tr r*xxr.w.rr-rL�.ar.rrwrr r fwe�l�wiw�+wtr�+t++rrr <br /> 61IICTION I - SX Envitdrnmint9l Nei kh Departmaot'a Tank Tra(*Ing Shoe shall avomp” o.oh wink r't with it# $ft <br /> itsonlikattlon number. 1-bo Ta(* Tracking Sheet is td be returned to me Erlvironmordw Hsatth Department m6tstilt�M-m of <br /> eoceptanoo of the lank by ft dk"V ar rficyding f8ct[1ty, The pormit holder is responsible far erteuring that tnia farm is QutripbfiW <br /> and mtvrnwd. <br /> 5ACIL.ITY wAML City of Lodi Municipal Sarvice Canter <br /> mr,I t-Y ADORSSS: 1331 $. ham Lane Lodi CA 86242 <br /> TANK ID 130 ,•000 �jg"nnommos.TANK SIZE: R ,PREVIOUS TANK CONTENTS: 1N�asta Oil <br /> ,►-,�rvWMr+rWW,rfiw k,w�* �►� * • Www�wwwWwwww w�rt,4-4�e�r.w�—..-: ,tycx,��Fvt,Mi,*�r#-rW�,rvrr*�vx+�rRrinr�r�iY�* <br /> SECTIQN 2-'ro be Ahad out bylank removal 000ft(90r° <br /> 'Tank Removal COntrvAtor t i1 'r �L ! --.- _-- �� <br /> Rig- arx 2 `i 7 _. y Cihr 49 00 <br /> Pilo lie tk Z',�,.� f �'„� r,..�,Qa:d Ysak RemavW;_.T.....,.. <br /> ��wwW JFkWW#�rr►itA)}M ,1t/hhAN4+Awf+Hl+kits►+M41111ArMyFWUFW+tMY�FIf��M �tlrirt�rthkklnMMIY1M11i11MMNMAr�Mt+kaki►k Yi�►+h►krIrwlrlryt1lwlop W*** <br /> $CCTION 3-7o t)e Puled out by aoritmctor"docor'rlarrt`Inatin�g tante", <br /> T&M Dsacntamin an Contractor: � •'r 7_,. CT�rr_ s�.Y. �.. �f"� ' <br /> Address: x � — ...., C xy:_„_ �! W.zp- <br /> -- <br /> Aurhorlxad raprasentailve of ocntractor ortifying through signatura t4low that the tank Nm 1llln ipcontarnin9w In an approvwd <br /> m,mnw os requlmd by Cat F-PA, <br /> NIJAM0; <br /> rrnw�W*,4�y,r.►,1#ww+�+ www,twwy+rwwv.w,M.�,1-Mw+rrwww,rwr�ar,kr,►+w4+��tWW*kNw � rr �e�M* iNY1Wtk+r�+r,rr�r,r#r�*��w,4� <br /> SUCY10N 4-To be agnrd*Md dsted by an suthorlaed ropmwitathra of the stora►go, of dtsMvid facility <br /> swepting tanX andlOr piping. <br /> Pac+iity Naime; ,.— <br /> Address: le ct A4 C JP: <3 kil <br /> Phare#; LZ02L 6 k/9 3 7-or 5 <br /> Date TW ¢pawed: - <br /> � <br />