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r.. <br />r <br />SAN JOAQUtN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />#+#++#t++af#rf++a++f•#fro#►/rr4it♦+flf++##ff+#}tri#+rr/r#i4r/+at+#+ttff+arlaaaaaflslasasf!lataaalaal+alas!! <br />SECTION l - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br />with its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health <br />Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for <br />ensuring that this form is completed and returned. <br />FACILITY NAME: Stockton Metropolitan Airport E.P.A.11 CAC001357712 <br />5000 S. Airport Way, Stockton, CA 95206 <br />FACILITY ADDRESS: <br />TANK ID #39 - <br />TANK SIZE: 3000 ' a"'WEVI0US TANK CONTENTS: <br />gasoline <br />+#+##+###+#+##►##r+#+i+aa+#+a#iso#++ti++f++ii++aaa#+aalistf Yttffi+!#+rar#f•a+iitaa+laf!laasalafla►aalaffafa <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: Jim Thorpe <br />Oil <br />Inc. <br />Address: 351 N Beckman Rd./P.O. <br />Box <br />357 <br />City: Lodi, CA <br />Zip: 95241-0357 <br />Phone N: ( 209 ) 368-6175 Date Tank Removed: <br />#+++++#++++++++++++++#+++++#+++#++++++++++++#++++r++++++++++t+ifr++fIrl++#at+++++ail++++++++++++ssla►a+++#+ <br />SECTION 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: Jim Thorpe Oil, Inc. <br />Address: 351 N. Beckman Rd./P.O. Box 357 <br />Phone A: ( 209 ) <br />City: Lodi, CA Zip:95241-0357 <br />Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br />manner as required by Cal EPA. <br />Name: <br />Title: Signature: <br />4 - To be signed and dated by an <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel Products <br />Address: <br />Phone A: ( 916 <br />12000 Folsom Blvd. <br />Date Tank Received: <br />985-4810 <br />Date <br />Rancho Cordova, CA <br />City: Zip: 95742 <br />Title: Signature: <br />#++#r#f•++#+f++trir++/f+rt++f//f++//f+fr++//4i#+++/+rt4#/sir#+++4+rffir/+#f+++f•+++rrrrr►++f a+#1a+►rfa#►ra <br />Ell 23 046 (Revised 9/11/96) Page 10 <br />