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SAN J0iwr0IN COUNTY PU"UC HEA1,171 SFRVI,.,46 <br />F,Nv1RONMENPAL HEALTH DIVISION <br />UNDERGROUND STORAGE, TANK DISPOSITION TRACKING RECORD <br />aaaaaaaa♦aaaaaaaaaaa♦a«•a«a••aa♦♦aaa«alar+#a«aa##w«rrr•rr#aaara#alaaaa♦arffffMfffffffffffffgfffffffffffff <br />SFO'ilUN I - Pnbiic Health Services Frtvironmcntnt Ilealth Division Tank Tracking Sheet shall accompany each tank affixed <br />with its sitr Identircadon numher. Tire Tank Tracking Slice( ism he renoned to fhrblic Health Services Environmental Health <br />Itivl.^,Inn nilhln-JII dnvs of arceptnnce of the rank by fire disposal or recycling facility. The permit holder Is responsible for <br />ensuring that this form is completed and returned. <br />rACILIIYNAMr: RalnhIs Market. C.P.A. 11 CAC00074�A1� <br />fACILIIY ADDR FSS: 2122 S. Airport Way, Stockton, CA 95206 <br />TANK ID 119 - 1rtDy-03 TANK SIZE: 5,000 gals. PREviOUS TANK CONTENTS: gasoline <br />........a.....aaaaa.«a♦#aaaa«#r«!•aa+a«•♦aa.#aafaa!•aala#a+rrrlaala+aaafrrr♦aafr•+alaafffwafffafffffffffff• <br />SFC'ITON I - To be Pilled rat by fink removal contractor: <br />Iank Removal Contractor. <br />011. Inc. <br />Address: 351 N. Beckman Rd./PA, flux 357 City: LodiI CA zip: 95241-0357 <br />Plmac 1: (_ 209_) .368-6175 Date Tank Removed: <br />......a a......a..+•aaH#aaaaa•;lHwallaaa•aaHl+♦a#!r«#Maa•!•••#H!#aflala♦afNfwfalffffgffffffffffffffff <br />SFC'i'tON J - 'Fo be rifled out by contractor "decontaminating funk": <br />lank Decontnodnntion Contractor: Jim 'I'Irorpe 0111 lac. <br />I N. Beckman rd./P.0. Box 351 <br />Phmve 1: ( 209 ) 368-61 <br />City: Lodi, CA z)p;95241-0357 <br />Mnlutrf7rd repte-%enintive of cmnrnctor certifying through signature below that the tank has been decootaminsted In an approved <br />rammer ns ralithed by Cil EPA. <br />Nmue:_Moti i u R pe Title: �y Z) f� Signature �1,r� Dere [ a 3� �� <br />as ` s raa"`rlaa` ar as ges anU`liadro ar'6onria orssrru'on'deilve"r '�`ti rd�iniMgr tee]. <br />1`ank `is Cree o aft sludges an yy tt CC pp pp <br />SECTION 4 - To be signed and dated by an ant ftorized representallve of tiie treatment, Me age, or silos acfl ty <br />accepting tank and/or piping. <br />Facility Name: SClujLzer Steel ProducLs <br />Address: 12000 Polscan Blvd - <br />Phone 1: ( 9 16 ) 985-4810 <br />Date Tank <br />Native: <br />aaaaaaaaal\a+aaa+a��aaa+a++aaaaa++a•+a+++a <br />liancho Cordova, CA <br />chy: zip: 95742 <br />aarl++r4aa•rr1laafla <br />Pit 21 Ott (Revised 9111190) Page 10 <br />