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SAN J�LLN COUNTY PUBLIC HEALTH SE <br />R*weES <br />ENVIRON, IENT.AL HEALTH DIVISION <br />L-NDERGROLND STORAGE TANK DISPOSITION TRACKING RECORD <br />SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed with <br />ntal Health Division <br />its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environme <br />recvcling facility. The permit holder is responsible for ensuring that <br />within 30 days of acceptance of the tank by the disposal or <br />this form is completed and returned. <br />FACILITY NAME: SOUZA II LLC <br />FACILITY ADDRESS: 612 W. 11th S 7 _ <br />TANK ID Y39 - TANK SIZE: 1. 6 p PREVIOUS TANK CONTENTS: <br />SECTION 2 - To be tilled out by tank removal contractor: <br />Tank Removal Contractor: JIM THORPE OIL, INC. <br />677 E. Lockeford St., P. 0. Box 357 Cin,. Lodi, CA Zip: 95241-0357 <br />Address: f0 Lg- /O / <br />Phone #: ( 209) 368-6175 Date Tank Removed: / <br />SECTION 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: JIM THORPE OIL, INC. <br />Address: 677 E. Lockeford St. , P. 0. Box 357 City: Lodi , CA Zip: 9524]-03S7 <br />Phone X: (_209 ) 368-6175 <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: Martin Thorpe <br />ebad2td ynTo signed n <br />accenting tank and/or piping. <br />0ypjpentrAt4KMrRt9Ge. �094;prac�it�-,el . <br />Facility Name: Schnitzer Steel Products <br />Rancho Cordova, CA 95742 <br />s.�a.P - 12000 Folsom Blvd. City: Zip: <br />Phone #: <br />Date Tank Received: /11/o <br />Name:�t a <br />EH 23 046 (Revised 08/13/99) <br />Page 10 <br />/'jo <br />