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SAN's, AQUIN COUNTY PUBLIC HEALTH SER-..CES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall affixed accompany each tank aed with <br /> its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health Division <br /> within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for ensuring that <br /> this form is completed and returned. <br /> FACILITY NAMF: Franks Tire Service EpA # CAC 002127664 <br /> FACILITY ADDRESS: 5023 Market St . , Linden , CA 95236 <br /> TANK ID R39 - .V &3,0-5—TANK SIZE: 500 gal. PREVIOUS TANK CONTENTS: leaded gasoline <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Jim Thorpe Oil , Inc. <br /> Address: P.O. Box 357 City: Lodi , CA Zipp: 95241-0357 <br /> Phone #: ( 209 ) 368-6175 Date Tank Removed:_ " _j <br /> (F 0 <br /> SECTION 3 -To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: Jim Thorpe Oil , Inc. <br /> Address: P.O. Box 357 City_ Lodi , CA Zip: 95241-0357 <br /> Phone #: ( 209 ) 368-6175 <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Name: Richard Thorpe Title: Contractor Signature: �ate <br /> E TI N a o be signed and dated b an authorized representative�f the treatmen��r storage, or sposacily"�`EL#**## <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address:12000 Folsom Blvd. Ciry: Rarcho Cordolip; CA 95742 <br /> Phone R: ( 916) 985-4810Q <br /> Date Tank Received: / p <br /> Name: �dyf (r����Title: 1F��6�11Ma�tQ.� Signature: 01 ya Date 1 <br /> EH 23 046 (Revised 10/19/98) Page 10 <br />