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PUBLIC HEALTH SERVICES <br /> ' SAN JOAQUIN COUNTY <br /> a � � <br /> • JW KfiANNA 611),UP If <br /> . <br /> Health Officer <br /> P llox 2009 • (I((f1 Fast Ilarciton Avrnue) • Stockton, Callfcxnla 95201 <br /> (209) 468 3400 <br /> UNDERGROUND IANK DISPOSIIION IRACKiNG RECORD <br /> R0••!!!•#••!#!0f♦•lffifi!!f•iff!•!!!•#!f!#!!.!!••R!1!lfRffRfliiilfffi##ffRRRRi#!#!#!#R!!#!lffll!lfffflfilRR <br /> Sr(.i ION 1 - i tthllc Ifeallh Servlecs irick Ing Sheet will accompany each lank affixed with Its site identification number The <br /> 1 Larking Sheol is tit he returned to Public I leallh Services willtht 30 days of acceptance of the lank by the disposal or recycling <br /> facility I he permit holder is responsible for ensuring that this form is completed and returned <br /> rAGILIiY NAME INDEPENDENT TRUCKING COMPANY EPA # CAC 000979040 <br /> rACiLi f Y ADDRESS 1145 W Charter Way, Stockton , CA 95206 <br /> TANK lD #39 . 505406` 02 lank Description 10,000 gallon Di sel <br /> •.••!•••0!1!!••R••Rlf1•!!!!!lffiff•••.#••Rff!•RRf!!fR•iff•!ilii!•iRR!!R!!•R!!•###!!#!!!###!!#!!R!!f!#R!!!R <br /> SRUI iON 2 - 7o he filled out by lank removal contractor <br /> Intik Removal Contractor JIM THORPE OIL, INC. i)BA RICH-MART CONSTR. <br /> Address 351 N. Beckman Rd. , P 0. Box 351 City Lodi , CA Zip. 95241-0357 <br /> Phone # ( 209 ) 368-6175 Date lank Removed October 4, 1994 <br /> ` 4046•.1##•!i•#!#♦f•#if#•!##•!##•••iif•f#1iiiff#RlRiliiii#lifiiff•#iRRiff!#!!!!##fir,##!!�#!!!#Rif#!#ff•#!!#♦ <br /> �FCf iON I - to he rifled out by contractor "decontaminating tank"- <br /> lank Decontaminallott Contractor JIM THORPE OIL, INC. HRA RICH-MART CONSTR./Nor-Cal Oil = <br /> - Hauler of rinsate <br /> Addresr 351 N. Beckman Rd , i 0. Box 357 City Lodi , CA Zip. 95241 -0357 <br /> Phone # (__?09 ) 368-6175 <br /> Atttbarf7ed representative of contractor certified by signing below that the lank has been decontaminated in an approved <br /> manner as required by the Slate Department o Ilealth Services <br /> Slgnsttttre JJ Title- Vice-President <br /> R ft #•A#• #000.0 •! f! • i1l0•#•• ►Rl4lfR♦• ***to too • �!#1f#f #f! ♦ !f!!#RRR##Rif flflfi!! <br /> Tank is tree off' afif s'1'uj9es and#hydrocarban vapors Hors upon agIivery to S'c�iriid�zer Stele . <br /> SECi iON 4 - in he Signed and dated by an nuthorired represer tave o the treatment, storage, or sposal fac y <br /> accepting lank anti/or piping <br /> rncilily Name Schnitzer Steel Products <br /> Address• 12000 Folsom Blvd. City Rancho Cordo Zip- 95742 <br /> Phone # C-216 ) 985-4810 <br /> Dare lank Received <br /> Slgnamre Title, <br /> •••�•••*•••f•##••••••••• .#f#ii• #•#•#iR••••#!•!••••••#i♦ff•fRfii••i•##•#!#!!lRffiRf•ff iff•##!!!!!ff!! <br /> Page Io <br /> F" 23 049 (Rev 2/8/91) ,P <br /> A D100 rrt or S•n Jowmrin t obnty health fere RrAce.1 �� <br />