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SAN JOAQUiN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL IIE,ALTiI DIVISION <br /> UNDERGROUND STORAGE "TANK DiSPOSiIIJ0N TRACKING RECORD <br /> aaaaaaaaaw++aa«+aa+a+wa+++raa+++atrrar++tt+a+r++r++awwarrrrwrrrw+rr###rr#*##****+#####4####4##44#4444#4#4## <br /> SF(:TION I - Public ficalth Services Environmental fiealth Division Tank Tracking Sheet shall accompany each tank affixed <br /> with its vitr irfrntification number. The Tank Tracking Slice( is to be returned to Public health Services Environmental Health <br /> I)ivi^inn iroithln 30 dnvs of irr.rptanct- of the tank by the disposal or recycling facility. The permit holder is responsible for <br /> r.nsttring that this fonts is completed and returned. <br /> FACII-1I Y NAMF:_f al h', mgr kp E.P.A. If CAC nnn743g1F, <br /> FACIVI I Y Ar)r)Rr-ss: 2122 S. Airport Way, Stockton, CA 95206 <br /> i'ANK 11) #39 - TANK .SIZE: 12,000 gallomEV1OUS TANK CONTENTS: gasoline <br /> aaaaaaa aaaaaa+aaaaaaa++w+++++awwrta+r++t+rra++rw+twrr*wr#rrr4r#r##r####*############*####*444444##4##t4#+4# <br /> S�C'11ON 2 - 1-o be rifled out by tank removal contractor: <br /> lank Rr-ntoval Contractor. Jim Thorpe Oil, itis <br /> Addtcss 351 N. C3eckman Hct./P.O. Uyx 357 City: Lodi, CA / Zip: 95241-0357 <br /> Ninnr #: ( 20-9 ). 368-6175 Date Tank Removed: lo/ C) 2 <br /> SFCTION 3 - To be rifled out by contractor "decontnminnting (ank": <br /> lank i)econtamination Contractor: Jim 'I'ttot'pe Oil, lite. <br /> Arlrltcss: 351 N. Beckman Rd./P.O. Box 357 City: Locii, CA Zip:95241-0357 <br /> Phone l: ( 209 ) 368-61"l5 <br /> Amlinti7rd rcprrsrrrtative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> mmtnrr as rr.fpdrrd by (',if FPA. / <br /> Barite: m/ �f r,J t�-p2_Title: ! 0 Signature:` rJ �Date v7 <br />. aa+ a,a,aa ++aiar t,a« ar +w •wr+ars + ++ •r.•ra ra+.rrrar##r+arr#aa- - - -- - -- <br /> an <br /> # t**+# <br /> anfiCa is firee ofi a�`fi stud es an$ �t c�rocarfiion vapors u on de livery to SChni tZer Steel . <br /> ir( I ION 4 - f-o be .signed and dated by an autriorized representative of the treatment, stoiage, or disposal facility <br /> accepting tank and/or piping. <br />'acility Narnc: Schrt.iLzer St,oel Pt'OdUCt.S <br /> R�t)cho Cordova, CA <br /> lrldtcss I�UUU I'c)1 scan i31vd• City: Zip: 95742 <br />'Itrntc 11: ( 9 16 ) 985—/010 <br />)arc Tank Received: <br /> faille: Title: Signatur . Date <br /> aa+aaaaa++++ari+r#+##rarwr+r+#+++++a•+#r++r+#ar#r#r*##a#*r**##r*r*#ra#***##4#*#4#*44####444444#4+M444##4+� . <br /> 11 2.3 016 (Revised 9/11/96) Page 10 <br /> 1 <br />