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`a®�Q44R49t#4Rpt4aQQttatQQt4Q#RtRQRARgtlal4i4RRlRA44RpgRRRWRARBa/g9PaaRR4rR191604R4iQQ9trR!!q� .. <br /> `. .'YC i - 'tea sasn Joaquin 1Wlth Disstriet's 'Yraurkln0 Nat Will t <br /> jUl With 1t2 Oita identificsation nuad*r. 'limas Trackingtis teBSn:aQ to <br /> Rain icwml Maith District +within 30 days of N=Ptawa of tha tmk by d1opwal or <br /> -jMclinq facility. <br /> G[E.dTy Pony Express Courrier �- oOd .,ter �•�� <br /> LIgV : 959 Moffat Blvd., Manteca, CA <br /> i PAWID ��_ _�L` — EPA Site .1 CAC 000195488 <br /> @A4RRtttQR#t#R. aiatQ4titQRRRRQt44RRQs4R#442QQQ4Qa4QRt�lAQRtr#t4RRQRRIIagiRRPl8R4Qga4s �m4e8Qi*�A <br /> ON - 2 - 1b be filled out try tw* to wml swtiactor I <br /> Jim ThorpeInc. r <br /> � 1 Cbndractar• iThe OilInc '.95240 <br /> _ 351 N. Beckman, Road= LcJi, CA gl 1 <br /> 1): p a'9�4i- <br /> �'@alaiplwne: I �.3 Data ftM gads <br /> @gRlRR4444RQRattt#tt4444t4Rt4ttttttitQQAftQaRg4iiSRRli4di44RiARgRi➢& !ll44ARgil�4iA�RRRaiQ4li! <br /> 14MCM 3 -To b,� filled out by contr&Ctat RdeontJFSitmtinq t+ *111 <br /> i'Vbmx*azas1n®tlon" Cantract=I slim Thorpe Oil, 16C. 1 Nor-Cal wily Hauler of ritasate <br /> 351 N. Beckman Road, Lodi, CA Zip: 95240 <br /> horlsad aapzesentatl contractor rtifl®s by signing b*1or: tt�t the tgrsk � �n <br /> a�taad in an be requ tat Ds �t o tle�l s cvtt�aa. <br /> dI014A'Igd� !'1'I'd� <br /> iiA�444Rt4RtttttRteeQtttaRt#Rtttttttttta9rt444ts'��t4�tt:10t4RRQQRR4QRQRtARQ4RRtRQR}tRRQRta#ttt <br /> MMION 4 To be filled out and signed by an 4,ut1r+T.&=d $epre:aasstntive of time trestraarrt, <br /> , or dlapossa3 facility accapting tank. <br /> tlIIty <br /> ihA�xmes. o�etl oas3� oi; wd Zipr -- <br /> ZED IC 'R ASID TIUA <br /> a .. 4lipl/ttf�08l4t4l4stR4RtQ11a!litiRRttllkRtt <br /> wit*4!!Rattatea0ilAtRt�tyllRlRlfllRsttilRiR4g0atAtR <br /> -. �-' �-1� OA9-It/00 --- --- •.. � -- - <br /> �g <br /> I�l4 lION8: >w IN Luz no 8vm. kmx PROFS P067=6 <br /> A'1`itt: UMERGROWTk19i 1 <br /> P. t?. 8= 2009 r:> <br /> r' ,99CiC7(RC8lm ® 952 } <br /> r <br />