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�r J(X)l KHANNA 111),MP If <br /> Ilrsftit 0111(rr r �T <br /> -- 'Zfrra�►a <br /> p U flax 2(x)9 (imii Fast Ilaielton Avrnue) • StvCkton, C�dlfornls 95201 <br /> (209) dM 3400 <br /> UNI)I;St(,ii(1UN1) IANK i11Si'()SIIIUN IIL1(-KING RECORD <br /> •.� . .parr•aarrarrars.r►r•a♦aaaa•r►r►•••parr■a■a►rr♦atoo►aaaa.r•arararara..r.al.■rltoo.•rr..r.....rl.a.rra <br /> 1(e•titit Services irlckrr►p Siteel %vr1i acrompiny cach tank affixed with its site idcrtliiic (non number T <br /> 1 parking Sbert i5 In be rcttrrrtcd rpt [uhltc i lcaith Services ,vitltin .]y ay of acceptance of the tank by lite disposal or reryci! <br /> f,rclliry I he prrrtiit holder is responsthlc for ensuring that this form is completed and returned. <br /> i I1ULI I Y NAME Boettcher Westerri Pro erties l i t Ltd <br /> T M 11 11 Y ADORCSS 4555 N. Fersho-ng Ave. Stockton, Cal �f <br /> 12 000 al Diesel F <br /> 1 nrfK iU ry 19 - �1! 7 � � �� � tank Ucscrilrtfon r g_ <br /> •rr•a•.r•r1r►r►raaEPA aS;te a# C1;C�.��:�2 Q:.q.............. <br /> ►rarrar•fart..pool, ............ <br /> W Sr.t"T 1r)N 7 J() be filled out by tank rerttftval contractor <br /> lank Removal Contraclor JIM T1 ORPC OILS INC DBA RICII-MART CONSTft <br /> llrhlrr-,C 351 N Ber•kwan Rd 11 0 Box 357 city Lodi , C11 Zip 95241 -0357 <br /> Al <br /> 209 368-6175 U;tte lank Removed C �� <br /> 1'1rr7rtc �' ( ) <br /> , „• ,►r•a� arr►a•rr•♦raa■r••r►a►a+•►ar•rr►r!•rrrrr•arrrar•rrl/ra.•rrrrr.rll..1!l1..l.l..l....li..!l...f l.+ <br /> ST "f If tN 1 tri he filled owby contras for 'ciccc)ntarntnatirtg tank". <br /> lank Uccontnrrtinatlon Contractor JIM TIIORPE OIL , INC 01311 RICH-MART CONSTR /Nor <br /> erl o �r�nsa t <br /> Addivss 351 N Beckman Rd , P. 0 Box 357 City Lodi , CA ZIP 95241 -0357 <br /> f boric r1' ( 209 ) 3613-6175 <br /> A„rhr7►l7rd rrprr-srntitive of cr,111ractr7r cettlfrcd by sipnlng below that tire lank has been decontaminated In an approved <br /> nr^inncr as rcrluirccl by the Stitc Departnt nt of Ilcaith Service,-, <br /> Title Vice-President <br /> �-- <br /> - fank is free of all sludges and hyd rrbon vapors upon delivery <br /> rr.ato Schnitzer. Steel <br /> . . ..a•••a■r•rra►ra•r1•rrarrr►•r•ar••a►a•••rrr•►a rr•r•■••rarr•►►r•ar•er r•aa r.rrr art...•1..er.rrrl.i <br /> 5F"(:iI0N 4 - Its 17e iipnerl and dalcd by an ntrthorl7ed rrpresentrttive of lite treatment, storage, or disposal facility <br /> -- ncccptlne tank and/)r itrlttng <br /> F-aciliry Narnc Schnitzer Steel Products <br /> Addrew 12000 Folsom Blvd. City Rancho Cordov ZIP 95742 <br /> fhonr 11 ( 916 ) 985-4810 <br /> l)11r lank Rrcclvccl <br /> �' Title• <br /> ^, Signntnrc � <br /> .......•.•rr..aa■•••r....►rr••+r.•••.r•. •a•r•••r•arrto.►.••►ar•atar••r►r ■carr•too ar.rrr.+rrrrrrra.rrr•++• <br /> • f''tgC Iq <br /> P11 73 049 (0ev 7/817t) up <br /> A r7 odor,nt tin Inupiln t nunr rrt�hh("re %CniCCr , <br />