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SAN JOAQUI`i 1 COUNTY PUBLIC HEALTH SER v ICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> pQWW= TOR-kGE TANK DISPOSITION TRACKING RECORD <br /> ABOVEGROUND <br /> SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed 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 NANIE: CENTRAL CALIFORNIA TRACTION CO. EPA SITE # CAL 000200959 <br /> FACILITY ADDRESS: 1645 Cherokee Lane, Stockton, CA <br /> TANK ID A- TANK SIZE: .576 PREVIOUS TANK CONTENTS: Diesel <br /> SECTION 2 -To be tilled out by tank removal contractor: <br /> Tank Removal Contractor: JIM TH O RP E OIL, INC. <br /> Address: 677 E. Lockeford St. , P. 0. _Box 357 City: Lodi . CA Zip: 95241-0357 <br /> Phone #: ( 209 ) 368-6175 Date Tank Removed: October 8, 2002 <br /> SECTION 3 - To be tilled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC. <br /> Address: 677 E. Lockeford St. , P. 0. 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: Martin Thorpe Title: Vice-President Signature Dated O2. <br /> T*anl is f ree o a*TT sT ua egg and h drocarbon va��rs �or>< �et ! erg tp ;Fq�S pract§iVel . <br /> SECTION 4- To be signed and d1ted by an au�hortzed represen a ive o era t, s ra <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Rancho Cordova , CA <br /> Address: 12000 Folsom Blvd. City: Zip: 95742 <br /> Phone #: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> .� GVH : Cl.�' wtr�lrc. Signature: Date <br /> Name: Title <br /> �O40L_� <br /> EH 23 046 (Revised 08/13/99) Pave 10 <br />