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SAPOAQUIN COUNTY PUBLIC BEALTH *VICES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDERGROM STORAGE TAINK DMOSMON TRACKING RECORD <br />SECTION 1 - public Health Services Environmental Health Division Tank Tracking Shy shall acconipagy each t affixed with <br />its site identification inimber. The Tank Tracking Sbeet is to be retamed to public Health serrices Emmmmeatal Health Division <br />within 30 days of accepunce of the tank by the disposal or recycling facility. The permit holder is responsible for =1164 thu <br />this form is completed: and returned- <br />FkCUM NAME: Marsili Property <br />FACHM ADDRESS, 3212 E. Woodson Rd. <br />�w- <br />TANK ID #39 - .T,,An SM. ;Zo�� 0 . ..... PREVIOUS TANK CONTENTS: <br />SECTION 2 - To be filled out by tank removal contr2dor: <br />Tank Removal C tra Jim Thorpe flit , Int~ <br />Aftess: P.O. Box 357 City. Lodi, CA Zip. 95241-03,57 <br />phone Date Tank Removed: <br />.(209 )_368-6175 <br />SECTION 3 - To be Oed out by entift-Actwadewnt=inating =kll, <br />Tank Decontaminadon Contractor Jim.Tjorpe Oil, Inc. <br />Address: P. 0. Box 357 City: Lodil CA ---zip: 95241-0357.__ <br />phone#:( 22iir19 ) 368-6175 <br />Tank till D a ng igstQree of all sl e$ d tLj�roca b nmVa Xs- <br />Lgog <br />tor Mg trough sigw=e"' diat 'the been On In an approved <br />Authorized tepre==Uve <br />manner as r4q*ed by Cal EPA. <br />,Name- Martin ThorpeTittle: ContractorSignature: Date____� <br />SECTION 4 - To be signed and dated by an authorfted representative of the trown= storage, Or disposal facility <br />accepting tank and/or piping. <br />Facility N=el. Schnitzer Steel Products <br />Address: 12000 Folsom Blvd., Rancho Cordova, City: CA Zip: 95742 <br />Phone *- <br />MMIIMMIWTME� <br />Due Tank Received: <br />Name: —T'We: Sime: D <br />EH 33 046 (Revised 08/ 13199) Page 10 <br />