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L%ZWKWOsND TAW D[SPOSITI(V tiR=.irta RECM <br /> faRlsORlR#R!##a#ta#+iP,y@!Rll*R***fteaRtttRla#talRA!!t#Rxa91lR#a!?P4alRPRadatpR£!lAtilalkAP!#RRR <br /> ON 1 - The San Joaquin LA=1 Health Dlatrict,a hacking Ahset will aoCoa�rny each tau:1c <br /> AN _.tasd with its site Identi€ication nuzber. The Tracking Sheet is to be returned to Asn <br /> Josguin Local Health District within 30 darys of accept anc� <br /> tr, of the tank by disposal or <br /> liility. �g <br /> 4 <br /> 6'ACZLITY RAW:_ NflB:kfAG.._L C <br /> F=LITIf AD g: 62'5 Tam O'SPanter, Stockton, CA <br /> TA1dlf ID EPA Site A CRC 000180345 <br /> RtRRtttllR#R!#+t�.ttllQil!!a!!a/t*afllft�tAapall#!!#R#AaIR!lRR/llaa#!IR#0*RItR##allltRR!!a <br /> OW-lICH Z To be filled out $RxR#RlatlR <br /> by tiatrOc removal conttraetar: <br /> Itnk Removal Contracicorl-JIM TRnrPF OIL INC. <br /> 351 N. Beckman Road <br /> Address: —---_ 3 x 351 Lodi CA 95241-0351 <br /> Zip: <br /> 6 t 9(?U -36--8 <br /> Telephone: ante Tank Remavec!: 711.) ��I <br /> t!dltta*;'ta!!#tR,tasits,el�ea�r,e'�al�ralt:laQarset#al:.lRRro,r!#l�xltltRlRRloR�IRIR�t!!!Rll�lsaaRaa#R <br /> BION 3 -Tb to filled our by contractor <br /> "decontaminating taNc": <br /> It%* DOCwtami[lation" Contractor: JIM THORPE OIL / Nor-Cal, Hauler of Rinsate <br /> A 'a- ----- W E. Black Diamond, Lodi, CA 95240 <br /> --- Zlp: <br /> - - Fsorte6: 2 -n <br /> Authorized representative of c,)nt:aator certtfiea <br /> d sta8tinate9 in an aWzovr)d manner as nay by signing bele-.► that the tank hall been <br /> d requlatrxl by Deps.tment of Health Services. <br /> i =TIOK 4 - To be filled out arra signed by an authorized .tereanetativa of the treatment, <br /> ata�a�e, or disposal facility accepting tatsk. <br /> 1W-111ty 10m:oeW <br /> E 1 ZEll STF0. 'AO I CTS CL, <br /> Wdrew. ' 12000 FOLSOM BLVD. <br /> �--�_ 91b 98x4810 hone Zip: <br /> )site '!bolt Regie ive+d: �7 d' <br /> ftsCt!!!!R!!t#!#!t##3!*#!!!!##!! lRl9 R1t*!!ate!#! ll aD!#!! f 8111#!Rt#!#!!!#!II!#lRfts!#flRRRR!!! <br /> W 21 049 12168 <br /> Ql1L2MCI IN67RIJLTIarIS: FUM IN HALF AND STAPLE. APFZX PFt'M paGTA(Z. <br /> SSAN JO QUIN [,OM HEALTH DISUrcr <br /> AT TN: l6+ll6tcmcUND TANK pRq@i]1q{ <br /> P. G. BOX 2009 <br /> STOCKT N, G 95202 <br /> k; <br /> Nil <br />