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PUBLiC ZLALrfI I SI;IWICLS ,aF�� r.� <br /> SAN JOAQUIN COUNTY <br /> JO(-I KHANNA M P..M.P.H. <br /> I Iai1h <br /> P.O. Ilex AW s (IWI F.95111archon Avenue) a 511Kklun, Callfinith 95201 �IIkISA't <br /> (209) 4G8 }Nw <br /> UNDERGROUND TANK DISI'OSI'I'ION TRACKING ACCORD <br /> SHA fort I - 1'ubllc I lealth Sclvlccs'I'tncking Sheet will auvolliany each lank of fixed with Its site IdenllNca110n number. 7110 <br /> I larking Sheri Is i,,he returned In Public I leap(Selvices Ivlhiln JQ_dnyl of acceptance of the lank by(lie disposal or recycling <br /> facility. the penult hulder Is tesponslble lot cosurbng Ilial tills fun,, is completed slid returned. <br /> FACILITY NAME: Indpendent Trucking Company EPA 11 CAC 000979040 <br /> ITACII-11 Y ADDRESS: 1145 W. Charter Way Stockton, CA 95206 <br /> Gallon (gasoline) (diesel) (woil) <br /> ol) <br /> 'TANK IU #39 •- 'Tank Ucsalptuu: 1 ,000 <br /> SIiCI R.)N 7, - To be Illicit out by lank removal contractor: <br /> Innk Removal Contractor: JIM 111ORPE OIL , INC. DILA RICII-MART CONSTR. <br /> Addteslo 351 N. Beckman Rd. , 11. 0. Box 351 City; Lodi , CA Zip: 95241 -0357 <br /> Phmne N: ( 209 ) 368-6175 Date Tank Itennoved: <br /> SECIloN .1 • In be filled out by contractor 'decoldnniholdng Innk": <br /> 'Innk Dcconlatorn atoot Contractor: JIM 111010E OIL , INC. <br /> NC BBA RICII-MARE CONSTR./Nor-Cal Oil <br /> ler ot r nsate <br /> Address: 351 N. Beckman Rd. , 1'. 0. Box 357 City: Lodi , CA Zip: 9524 1 -035 7 <br /> Phanc b: ( 209 ) 360-6175 <br /> Aulhu/lzed relnesenlative of cunonclot cettlled by slgning below Ilial the lank has been deconlanllnaled In an approved <br /> manner as tegeired by the Slate Departrncnt of Health Services. <br /> Signntule; '1111e: <br /> • •• •• •. ..•.• •. •.. . ••..••.. •..•.•••• ..••.••.•i••••••••. • ••••.•to OV, <br /> • ••••••••....• ••u•••• <br /> Tank (s vFee oYall s(udyes ane(lrydrocarLoil vaurs upon delivery l V,(Iril[zer Stei� �y <br /> SECT loft 4 . 'I'll be signed and dated by an nuthorlrcd Iepresel tnllve u the Irealmcul, storage, lir d sposel far 1 <br /> accepting lank and/lir piping. <br /> rnclllly Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. city: Rancho Corkvivlp: 95747 _ <br /> Phone N: ( 916 ) 985-4010 <br /> Date 'lank Itecelved: <br /> Signalmc• I life: <br /> rage It <br /> Irl tl 069 (a!V 2/a/91) ••r• <br /> A bud+inn d¢n JmTdn 1'.nunry Ili-11h U¢Rn/co <br /> \� <br />