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SA7WUAQUIN U <br /> C'ONT'Y PUBLIC HEALTH S,..,VI('F.S <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE,TANK DISPOSITION TRACKING RECORD <br /> SECTION 1 - 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 /> FACILITYNAME: (Former) Rtnrktan Metrosrans nis+' <br /> FACILITY ADDRESS: 730 E Channel St , Stockton, CA <br /> TANK ID#39 - TANK SIZE: 1 000 PREVIOUS TANK CONTENTS: Unknown <br /> SECTION 2- To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Oil Equipment Service <br /> Address: P.O. Box 950 __ CitySan Andreas Zip: 95249 <br /> Phone#: ( 209 ) 754-1808 Date Tank Removed: <br /> SECTION 3 - To be tilled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: Oil Equipment Service <br /> Address: P.O. Box 950 City Ran Andreas Zip: 95249 <br /> Phone#: ( 209 ) 754-1808 <br /> Authorized representative of contractor certifying through signature below that the tank has,been decont inated in an approved <br /> manner as required by Cal EPA. <br /> lip <br /> Name: Keith A. Tallia Title: Pres-- Signat e: Date <br /> i h allia <br /> SECTION 4-To be signed and dated by an authorized representative of the treatment, storage, or disposal facility <br /> accepting tank and/or piping. <br /> Facility Name: WestCoast Equipment — <br /> Address: P.O. Box 2368 —_---City: <br /> .__- City: Turlock _Zip: 95381 <br /> Phone#: ( 209 ) 668-9378 <br /> Date Tank eceived: �i <br /> _ �3 <br /> Nam . Title: Owner _Signature: ate <br /> uie a ista <br /> EH 23 046 (Revised 03/13/99) Page 10 <br />