Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC HEALTH SER CES <br />ENVIRON MENTAL HEALTH DIVISION <br />UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br />SECTION I - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed with <br />its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health Division <br />within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for ensuring that <br />this form is completed and returned. <br />FACILITY NAME: �)uu[N tt <br />FACILITY ADDRESS: 612 W. 11 th Stn� Tw- '-,A 9.5176 <br />TANK ID #39 - <br />TANK SIZE: / S -W PREVIOUS TANK CONTENTS: Gly <br />SECTION 2 - To be filled out by tank removal contractor: <br />Tank Removal Contractor: JIM THORPE OIL, INC. <br />677 E. Lockeford St., P. 0. Box 357 City: Lodi, CA Zip: 95241-0357 <br />Address: <br />Phone #: (_.209 ) 368-6175 Date Tank Removed: <br />SECTION 3 - To be tilled out by contractor "decontaminating tank". <br />_ _Tank D&conrgttLtnL_ <br />JIM THORPE OIL, INC. <br />Address: 677 E. Lockeford St., P. 0. Box 357 _ <br />city: Lodi CA - —Zip: 95941 -0357 - - <br />Phone #: (_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. Dale to //� <br />Ll I <br />Name: Martin Thorpe Title: VP — Si gnatur <br />T+an�c is free o aslt�c�age� an h]drocgbopn yapaKl y ARj!X rs�,r�,�phQUpact5i <br />SECTION 4 - To be signed an to by ana bonze re res n a t o r <br />accepting tank and/or piping. <br />Facility Name: Schnitzer Steel Produ <br />Address: 12000 Folsom Blvd. <br />Phone #: <br />Date Tank Received: rj <br />EH 23 046 (Revised 08/13/99) Page 10 <br />Rancho Cordova, CA <br />City: Zip: <br />95742 <br />WA <br />1+*46,41*****+*****+**+*++*+*++*+****** <br />