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S <br /> SAN IOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> «*«*#*+**#*#*###*+.**+*#***+++*#*+#+fit+#.+*#****######•+*#+*****+#*#*#*******+*++****#+*#***##*##+##++****# <br /> SECTION I Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br /> with its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health <br /> Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for <br /> ensuring that this form is completed and returned. <br /> FACILITY NAME: Ray Baglietto & Frank Rauzi E.P.A. # CAC0012 3 60 <br /> FACILITY ADDRESS: 8200 N. Hwy 99, Stockton, CA 95207 <br /> TAMC If) 1134 '�Ol o� "V TANK SIZE: 8,000 gal PREVIOUS TANK CONTENTS: gasoline, <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> 'Tank Removal Contractor: Jim Thorpe Oil ftic. <br /> Address: 351 N. Beckman Rd./P.O. Box 357 City. Lodi, CA Zip: 95241-0357 <br /> Phone /1: ( 209 ) 368-6175 Date Tank Removed: <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor. Jim Thorpe Oil, Inc. <br /> Address: 351 N. Beckman Rd./P.O. Box 357 City: Lodi, CA Zip:95241-0357 <br /> Phone N: ( 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: P;C,4 2 -e— Title: fL es Signature-/2w/�41Date 7 t?q <br /> + *A «•-#*+ *#*+f* ** s* ## #******r * ## #**f*t ************##+***+ # #*****r ►***# *1****+# tee #*+**# <br /> '�`an�C 7s Free o a`� s�fuges ani �yyrocaron vapors upon d`eivero Sin�tZer.�Stee . <br /> SEC'T'ION 4 - To be signed and dated by an authorized representative of the treatment, storage, Jr�tsposat facility <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 b: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> Name. Signature: Date <br /> Ell 23 016 (Revised 9/11/96) Page 10 <br /> i <br />