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. I <br /> SAN JOAQ11JIN COUNTY MFILIC IIF'AI,TII SERVICES <br /> FNVI[t()NMFNrAL IIF,A[.TII DIVISION <br /> 1JIMERGROUND S rORA(M WANK DISCOSITION TRACKING RECORD <br /> F+}+aaF++t+++a}}•t}}}*}+}}4+a+4}}++}***ta++*+tat++}++tttttttttltlt4tltl44l44##44#4#4#44444444 <br /> .ort A III I - I'uhllr. Ileallh Sel vices f?nvlronntrntnl I leafllr DIvlslnn Tank Tracking Sheel shall accompany each tank affixed <br /> Milr Ili +Ire Irlroill(knihmnumber. The 'Tank Tracking Shr.el Is In be reurrued In Public Ileahh Service$ P-nvlrotlntenitil Helilh <br /> 0100mi ttllhln JO'da v9 of arcepl.mwe of the lnnk by the disposal or recycling facility. The perml( holder Is responsible for <br /> P11.11111114 Thal 11111 form Is cnrupielert and rettrrned. <br /> PA(11.I1 Y UTANII's: Sun West Liquors 1;".1'.A. 11 CLIC 001359464 <br /> 2449 W. Kettleman Ln. , Lodi, CA 95242 <br /> Inc�rr.l I Y nitl►Rr:.SS: <br /> I MIK II) M 19 --ST 3 3600 TANK siZr: 10,000 gals.mr:mus TANK CONTENTS: unleaded gasoline <br /> 1«;;a;;a«;♦F+�+lea+«a1}aaaF}F♦♦F}}}Fa}a!!l+Fa}fFa}}}F}Fa+}+}}F}}}+++}++++++++t!}tttttltl4t!!�!!!!tl4�!!!!•*# <br /> SKC-t If 2 - I o be filled out by {ank revrownt canlr actor: <br /> lank Rrnv,val ('nntrartur: Jim 'Thure 011 Inc. <br /> Adhhem 351 N. Beckman fid./P.0. Uux JW City: Lodi, Cil _ zip: 95241-0357 <br /> I'hnnr 1: ( 209 __.)__.368-6 115_ Unle Tauk Removed: <br /> «;,a.;aa;«♦Ia a++FaaFala!}aFF+}a}Fa♦t}}FF♦}}}}a}}Ff F++}a+FaFa+at** +t+++lttt*!t*twtl4!!!*t4!l4444*•444!*�** <br /> sr(:i mu J Tn Ire n1lerl nut by cnntrnclnr "decontaminrrtlnR tank": <br /> Innk Irccnnlaminnl[tnr ("nntractvr. Jim Th"n-pe 011, Inc. <br /> MIfhrm 351 N. Beckman ltd./I'.0. Box 35'1 City. Lucll., CA Zip:95241-0357 <br /> ('hnnr N: ( 209 ) 360-61'15 <br /> Atttlimlyrts ielrtelrnlallve of conttaclor cerNfying lrrrough signature below dint the tank has been decontuninated In an approved <br /> nlnnnct as tetlul►ed by Cas Earn. <br /> Home: �C QLu UQ/ 1111e: �IVe� Signature: A <br /> -)-at <br /> .f♦ « ;aa }+�++i !aF F }t tt++F++ + }+ ♦t++tt ++++*tttttt! •+ttt* t tttt!! !! ! * •#444 #444 444#444 <br /> �al �C pis free o� afr �11�c1g fs andlLyrlroc arf)ort va�iors 0 )01 �e �ver�r o r��in ��r <br /> ION d - 1'n he llquetl and $ter by an ant for 1e rept-mel Irre of{Ile treatment, Ito age« or In ttc1l t <br /> acrepthig milk Anel/or piping. <br /> I'n�llhy lJmnc: Sc:Itltll.zet• 3teei I'rcxlltcl.s <br /> It:incho Cordova, CA <br /> Addtclt: W000 I i).Esc�nl Il,lvcl, City: Zlpt 95742 <br /> ['hr►ne I: ( 916 ) yf15--111-110 <br /> hltrur: � r1pb�� Title:_ �y -G✓ signature 2,�`1� Dote 1 �1 <br /> «•««.+«+l+F+}}lea+}♦+a•a!+}!•FF+FaF}}+}++}+}}a♦}}+}}}+•++}t+}}}tat++*++*tttt+R+tt1**I*tttttAA41'*!**4ttbMA ,. <br /> ?II 2.1 fldh (tirvsscd 9/I 1/g(1) Page til <br /> f <br />