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SAY JOAQUW COVITY PUBLIC HEALTH SERVICES <br /> ENN Mor,2,fLNT.kL HEALTH DIyISION <br /> UNDERGROUND STORAGE TANS DISPOSITION TRACKVG RECORD <br /> SECTION t -Public Hca th Servkm Environmental Health Division Tank Tracking Slice: shall acc=Peny each tank affixed wit". <br /> its sit:;centi'lcat:on number. %='Tank Tra:leag Sheet is to be remmed co Pubs:c Health Services Ehviratimental Heap Division <br /> wk ;n 30ims of acceotaace of the tank by the disposal or recycling facility. The permit holder is responsible for=curing sac <br /> this`.orm is completed and remr.=. <br /> FACILITY NAME; San Joaquin County Mosquito & Vartnr Control n; at1-C— <br /> 200 N. Beckman Rd. , Lodi,- CA 95240 - - <br /> FACILITY ADDRESS: Q <br /> -ANK ID#39- TANK SIZE: 000 IOUS TANK COV z�TS.l7�7� <br /> SECTION 2-To be filled out by tank removal con&=D r: <br /> Jim Thorpe Oil , Inc. <br /> -ark Remeval C.onrractor• <br /> Address: <br /> P.O. Box 357 City: Lodi , CA Zip: 95241-0357 <br /> phone R: ( 209 368-6175 Daze Tank Removed: <br /> v#yi»r.xsw#xw11#x=#a#iiir.iT.r«lir..•r.�}r}}i#s##»r}�#'�'"'�""�•#••xr»}#*a.#i»##x....'«"i.#.i sMiY##x:xr%rk#i.i.r#.. s <br /> SECTION 3 -To be filled out by contractor"decomaminating tank": <br /> Tank Docoataaunatian Cohaactor: JIm Thorpe Oil , Inc. <br /> 4ddrms: P.O. Box 357 City Lodi .—CA- <br /> 209 368-6175 <br /> Phonc M: (� <br /> Authorized representative of eon actor cerifymg Through tigaantre below twat the tank has ec <br /> been dontaminated in an approved <br /> Matz=as required by Cal EPA. <br /> 1 <br /> Date i <br /> Nam.; Martin Thor e Title: Vice Pres. Sig2ature: — <br /> r# «wYw#.ii1cF#i»»r.A:.#•.#.#xY}vxi*i.Yiltit4it�4 Yx#an#i=rN��n Steel.'• . <br /> PipinJ*1Y*P{' *'df#iai11 sludg�s h rgcarbzen oornM e ftie°d�:a e�t�v gC;LL^VrLLciiSIWW„iJd <br /> SECTION a-To be sigmd a,� ` o <br /> accepting y2”" Pipizg <br /> Far.'1ty Name: SCHNITZER STEEL P <br /> Address: <br /> 12000 Folsom Blvd. GtyRancho Cor ova Zip: 9 <br /> ?hone#: ( 916 , 985-4810 <br /> Date Tank Received: <br /> Sante. <br /> Title: Side: Dare <br /> ...x#.iiia..»'X#i#i+YF•'}w}r+ }+s.w4a*.Y.Yrir#r#r.dYiMii.......... <br /> ##al#i"1#axsY.*xfa. <br /> S3 _ C46 (Ile'%- <br /> imd08ii3!99) Page 10 <br /> - <br />