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UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> rta>aa>JlaYargt>rrHr Hrattrr Nrtra>+araltagil Y♦HYarHallrlaaa>aJH♦>laaNlr♦N!H!a>tf art!>rf lgrl Vrai HlY <br /> SECTION I - Public Health Services Tracking Sheet will accompany each tank affixed with its site identification number. <br /> The Tracking Sheet is to be returned to Public Health Services within 30 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: VOGUE CLEANERS EPA #CAC 001074600 <br /> FACILITY ADDRESS: 2315 N. California Street, Stockton CA <br /> TANK ID #39 . 1032-02 Tank Description: 1 - 500 gallon gasoline tank <br /> i •lraa!lar rf a>aftwtlr!laatallaalata+l ragrr rtalr•+++ttlrttl+raarrtaa+rrt+allra+rr+l rtla lr la+ltalrral r+all•r+ <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL INC. <br /> Address: 351 N BECKMAN RD. / P.O. BOX 357 City: LODI , Zip: 95241-0357 <br /> Phone #: (209 368-6175 Date Tank Removed: June 7 1996 <br /> rartaaatt>raa>rad>altt>ttarlarltttlrrltt+rtta rtt r+radar at+rtt+trra+rrrttar to+al ttttrattartt>allaarf alta t+ar <br /> SECTION 3 - To be filled out by contractor "decontaminating lank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC <br /> Address: P.O. BOX 357 City: LODT Zip: 85241-0-l57 <br /> Phone #: (209 ) 368-61Y5 <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an <br /> approved manner as requi ed by Cal EPA. <br /> -�- Title: PRESIDENT <br /> Signature: <br /> ' gr g♦ rraarratrrta>r >a>at♦ a!t >lrlt raaa+aa>rl>agulg+>rrtl♦aaaglg••lural trt•sura arrraarrrr>a!lrrf lr <br /> "tank p1p1n� are free q sluc��es a�1d Ihrydroc�rbo�1 vapors urRof d%ji8pgpb? C�- zer Steel . <br /> SECCION 4 • To a signed and date y an ant torlze re eseula ve o the reatme ora s al tai <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. city: Rancho Cordova Zip: 95742 <br /> Phone #: 9( 16 ) 985-4810 r/ <br /> Date Tank Received: 6 <br /> Signature: Title: <br /> . <br /> •au•Nr N>uaraguta•raarrlr Arra+alta•usalll rrtaurraaat+aa>arasratlr ra r>+rtl+r r!ltrlalraf agar!!! <br /> EH 23 049 (Revised 7-10-92) Page 10 <br />