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Imf <br /> 0611112014 16:12 v oPAU170U1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Telephone: (209)468.3420 Faso (209)468-3433 <br /> UNDERGROUNDSTORAGE TANK DISPOSITION TRACKING RECORD <br /> 400 <br /> SfiCTION 1 – = Environmental Health Departments Tank Tracking Show $*I oewmpsny each tank aRaed 'Mta1 Is elte <br /> idanttAcatlm number. The Tank Tracking Sheat Is to be resumed to the ErwimmWtal hleaah D6per4T"M vAMd 591M of <br /> accepLime of the tank by the d opwel or r"ding fedll y. The psrmd holder le rsep"ble for en*ong that thlx6RiFeildd <br /> and returned. <br /> FACILITY NAME: <br /> Levand-Brlpht property <br /> FACILITY ADDRESS: 3 East Eleventh Street.Tracy, CA 06376 <br /> TANK ID#a —_ TANK S12E 250 gallon PREV1OW TANK CONTENTS: unkawn <br /> fYMyM/FA1yWRf Rfi**Yy1,y*yyf R***4A*4y**#i4**AF*l**'MfiWW*'W r9iltiMRMI,yRAAM*Ryy W W11\Iy\W FMx1AHAAAYYARA{A*** <br /> SCC ION 2-To be filled out by UM MM*vsl Or tnictor: <br /> Advanced GeoErnvironmentel, Inc, <br /> Tank Rerncw61 CadncYa:_ <br /> Addrees: 637 Shaw Road,Stockton, CA 95216 Cm, AP; <br /> Pham il:C—� -(209)467.1008 POO Tank Removed; 01 May 2014 �.. <br /> Wy yyi yyW yy i W Yy**yM W 4 yARA\RARAAAMMAAAA*A h*AM W AyAA I,A*-kAi+W WyAi.'k�wWFYY MYM,4A44,�I/i/AAYAYAA W AAiYM*A*A** <br /> SECTION 3-To be filled at by oontraotor"deoontAminating tank": <br /> Tank Deconlattdnstlon Contrthd r, Advanced GsoEnArunmental,Inc. <br /> Address: 837 Shaw Road, Stockton, CA 96216 City: zip: <br /> Ptwne g.,( (206)467-1006 <br /> Autbofted repTsentative ol contractor w tifyinb through 31OWUM below that tHa tank has boon daeontandnated In an approved <br /> Mannar s•reared by Cel EPA, <br /> Nano: Wllllem 1_Ittle TMS Geologist gin eq; W , p� 01 May 2014 <br /> FFwi�aWyy'*y My W**MRMe MRAARFRR*wA*i****W.**A*4 A***.*#*yY FARy RWA WAW AAArMxRAWRARM/+YI,RAAWAAfMAWA Y AA*A4 <br /> SECTION 4•To be eland arxl dated by an authorized mpraaenesBve of the treatrrlent,atore06,Or dlsposel fadl6y, <br /> e00eptirig tartk endear piping. <br /> Facility Nunn: West Coast EgUlpmtnt_ � <br /> Address: P.0,Hox 2368 C ,; Turlock,CA Zip* 95381 <br /> Phone#:r V'/ I (o& -/8' <br /> Date Te Received; 01 May 2014 <br /> Name: Ttda:� Sigrunum 01 May 2014 <br /> Nd k-� <br /> 9p G <br /> 6s <br /> EH 23 046 (h16VISed VI/I 1) 9 <br />