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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />+#a+i###irf}+r#+#++#a♦++l+##44t##lt++fttltr+ftt!!i#+tart##►+tlr4##4rtr!♦rtt!►/♦!t//+/!►!!!4/!!!!!!/♦►/*!!!! <br />SECTION I - Public health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br />widt its site identification number. the Tank Tracking Sheet is m 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 CA0001357712 <br />5000 S. Airport Way, Stockton, CA 95206 <br />FACILITY ADDRESS: <br />TANK ID N39 - TANK SIZE: 3000 galloWEVIOUS TANK CONTENTS: Wsoline <br />�###+###tf++t+t#ff+4ftt4#+#trt##♦f#+####frttf+#tf4f4+r##t##+ttaf4!#4t4+}4441ir4l44!•►t►►►4l►tr►!!4f!!!t!/+► <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: Jim <br />Inc. <br />Address: 351 N Beckman Rd./P.O. Box 357 City: Lodi, CA Zip: 9 524 1-0357 <br />Phone p: (209) 368-6175 Date Tank Removed: <br />++#+++++t++++++tt+++t+++tsf+t+#+##4ttt+f##tt!###f++#rr#Ott#4tttt#+ft##!t#ora++++++++►+#M►t►l4+4!!+!!alt+!! <br />SECTION 3 - To be filled out by contractor "decontaminating tank". <br />Tank Decontamination Contractor. Jim Thorpe <br />Oil, Inc. <br />Address: 351 N. Beckman Rd./P.O. Box <br />351 <br />City; Lodi, CA <br />Zip;95241-0357 <br />Phone /: ( 209 ) 368-6175 <br />Authorized tepresentadve 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 />+1 arik' i s "f "ree'of" a'Yf"sl uclge"s" an <br />SECTION 4 - To be signed and dated by an <br />accepting tank and/or piping. <br />Facility Name: <br />Phone N: ( 916 <br />Schnitzer Steel Products <br />12000 Folsom Blvd. <br />Date Tank Received: <br />985-4810 <br />of <br />or <br />Date <br />Rancho Cordova, CA <br />City: Zip: 95742 <br />Signature: <br />Date <br />+4+#a+#t+f#+ftf#arl+f+ltt+t+#ar#4+tt+fft#+t+k+a+#t#at##arttrl+t+44tttflr#+t+attl4+rt4ltra4rt►!4+#4*tatl4• <br />Ell 23 046 (Revised 9/11/96) Page 10 <br />