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PUBLIC 1 SERVICES �Q��► � <br /> SRN JOAQUIN COUNTY <br /> JOGI KIIANNA M D,M P I I 4, <br /> '• <br /> • I V I)ox 2(x)9 • (KAM Fait flarelton Awntre) • Stockton, (.allkxnia 95201 <br /> (209) 460 340) , <br /> UNIWIM tOUNI) LANK 1)[3110511 ION IItACKIN[► RECORD <br /> 1#0x#x####•#r►Irlr•1•##•rrr#/•#/rrx•rx11#r###r#•r1#/##•###►##R►#•►►►1#►11►••####►►##••►f#►#•1##►►•►•#•##►#• <br /> SI'(-1 ION I - 1a111111c I Ie 11111 Selvicci I tnt.kInp Sheet will accompany Carlo Tank Affixcd with Iii site Identification nWnber. The <br /> 11.14111g 511ce1 flits be relirtncd to Public l icnith Services wlthln JD tlnys of ncrcPlance of the intik by the disposal or recyciln9 <br /> I,cility I he permit bolder Is responsible for ensuring that. this fo►nr Is completed and returned <br /> rA(-ILIIY NAMe INDEPENDENT TRUCKING COMPANY EPA # CAC 000979040 <br /> I'M-11,11Y ADDItCSS 1145 W. Charter Way, Stockton, CA 95206 <br /> 1ANK II) A'39 - 505406- 03 lank Uescripilon 5 ,000 gallon diesel Ni-- <br /> 111x•1r oft r#to*#•#Rrlr►►#II/r11/11.R•r•♦1#RR#r►R of 1.111.1 rrrle##Ir►•1#►#111►####r►►►1►#►►►►#•►#►►►#►►••►►# <br /> Sr-(.LION 2 - I he filled out by tank removal contractor <br /> Intik "Cnloval Contraclot, JIM T11ORPE OIL, INC. DBA R 1 CII-MART CONSTR. <br /> Addreir 351 N. Beckman Rd. , P 0. Box 357 City Lodi , CA zip: 95241-0357 <br /> Phone # ( 209 ) 368-6175 Date lank Removed- October 4, 1994 <br /> ►xllxxlx#11x#►#rr#•#1#1#11••r111r•Rrrxxrl/r•r1.1####►♦art.1►1.1##•�#•••►•N•►�►####►►►•►•►►►#►►►►►#►►►►s►#! <br /> I ION I - In be f111ed nut by cnntrnc for 'dec(mtaminating tnitk"- <br />�fik Occoninnilnpllon Contractor JIM 111011PE OIL INC. URA RICII-MARL CONSTR. Npr-Cal Ofl <br /> Hauler of r nsate <br /> Addresi. 351 N. Beckman Rd , P 0 Box 357 City. Lodi , CA Zip. 95241-0357 <br /> ('Heine # (__?Ug ) 368-6175 <br /> AMhorbed tepteientative of contractor certified by elgning below that the lank has been decontaminated In an approved <br /> mannet as requited by the State Vepnrtntcnt of Ilealth Services <br /> Slglrntllre <br /> Title. Vice-President <br /> J.� <br /> • #+ �• xx /♦•,r# #• •#• . rxxl;a"AWYArocarbon <br /> too### #♦#11RRfr####•####♦ 1 •rR•### ••• • ►#•►►►•####►• #####►## <br /> Tank i•s tree n#' all sfu�ges vapors upon delivery to 5cirlid zerSSt��i .S8CIION4 - Ioheilgnedand (laced )y an nuthurired repre%er tntive o lire treatment, storage, or sposal a' ty <br /> accepting lank and/or piping <br /> roomy Nnmc- Schnitzer Steel Products <br /> Addteiv 12000 Folsom Blvd. city Rancho Cordo Zip: 95742 <br /> Phone N (__2_16 ) 985-4810 <br /> Dare lank ttccelved <br /> Signalurc, Title: <br /> TV <br />�11x♦♦/•♦1♦•►♦♦1r•►11/1.1x# 1R1•R ♦ /xr1#R/R•11•IIR11••If###►####•####*111###!•••••###########•##►►►• <br /> rage 1U <br /> 91 23 049 (Rev 2/8/91) vp <br /> A Woon or Sart jwTirn(nunrr tttalih rare Scrvrcer C� <br />