Laserfiche WebLink
UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />SECTION 1 - 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 />recyciing facility. The permit holder is responsible for cusuring that this form is completed and returned. <br />FACELrNNAME: Airport Passenger Inc. <br />FACIUTy ADDRESS: 2305 S. Airport Way, Stockton, CA <br />TANK 1D #39 - o `! 7() — DQ—L Tank Description: 4,000 gallon diesel <br />.•..••.••......•••••..•....•....................................................................•.......••• <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Conuactor. Paydirt Excavating Co. Inc <br />Addrea 269 Oregon ST City: Ripon Zip: 95366 <br />Phoma d1:1 1209 599-2347 Date Tank Removed.- <br />.........•...••...•.............................................................................••..••••.•. <br />SECTION 3 - To be filled out by conirwor 'decontaminating tank': <br />Tarek DecontamiuUm Contractor. Paydirt Excavating Co. Inc. <br />Ad&U 269 Oregon St city: Ripon Zip: 95366 <br />Phone At:( 20V 599-2347 <br />Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an <br />approved maiLM n r9quirod by Cal EPA /l <br />Stgrwtute 7'j__C�,� Title: �. T <br />SECTION 4 - To be signed and dated by an authorlxd representative of the treatment, storage, or disposal facility <br />accepting tank and/or piping. <br />FaglRy Name:Cal-Coast Mfg. <br />Address: 1540 Lynwood city: Turlcok Zip: 95381 <br />Phone rt: f ) 209 668- <br />9382 <br />Duo TWLk <br />Title: <br />IN 23 Oi9 (RavlaW 7.10-92) pates 10 <br />