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i <br /> UNDERGROUND STORAGE,TANK DISPOSITION TRACKING RECORD <br /> ••,•r•••r••rrr•••r••••r•••rr••••••••••••••r••••••••••••••••••••••rr••••••••••rrr••r•••rrrr•r•rrrrrrrr,r•rr• <br /> SECTION I - Public Ilealth Services Tracking Sheet will accompany each lank affixed with Its site Identification number. <br /> The Tracking Sheet Is to be returned to Public health Services within JO days of acceptance of the tank by the disposal or <br /> recycling facility. The permit holder Is responsible for ensuring that this form Is completed and returned. <br /> FACILITY NAME: O 2" e e EPA #(f/�L, DO O 6ao <br /> FACILITY ADDRESS: .2 c5 QC� <br /> TANK ID #39 - I D Aja — 01 Tank Descriptlon: sod g <br /> i <br /> .••,•.••••••••r••••••••r•r•••r•,•.••••••.••.u•.•••••r•rr••••••r••rr••••rr••••••r,urrrr••rrr••rr•r•rrrrr•• <br /> i SECTION 2 - To be filled out by lank removal contractor: <br /> Tank Removal Contractor: JIM TIIORPE OIL INC. <br /> Address: 351 N. BECKMAN RD. / P.O. BOX 357 City: LODI, Zip: 95941-0357 <br /> Phone #: ( 209_) 368-6175 Date Tank Removed: <br /> SECTION J - To be filled out by contractor "decontaminating lank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC <br /> Address: P.O. BOX 357 City: IOW Zip: 95941-0157 <br /> , <br /> Phone #: (209 ) 368-6175 <br /> Authorized representnllve of contractor cerlifyhtg through signature below that the tnnk has been deconlaminaled In an <br /> npproved manner as required by Cal EPA. <br /> Signature: Title: PRESIDENT <br /> all R p�p�n� are Tree ��� Slua�es aNd hydrIcArbop va�g� t oy �1g�iX�C1Ypb4 zer Steel . <br /> SECT' ON 4 - "o a signed and date y an nut?,es represeu n ve o the r t�ne , o s alq�� <br /> accepting lank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. city: Rancho Cordova Zip: 95742 <br /> Phone #: 9( 16 1 985-4810 <br /> Date 'rank Received: <br /> Signature: Title: <br /> •♦•r••••.•••u••••••.•••••••,••,•.••••••••••r••••••••••••r••r•••••••r••rrr•rr••r•••••rrrurrrrrrrrrrrrr• <br /> Ea 23 049 (Revised 7-10-92) Page 10 <br />