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SAN JOAQUN cOLV'YY PUBLIC FIE iLTH SZRVICESa`- <br /> ei MON-MENTAL HEALTH DI1'ISIGN <br /> CNDERGROL•r'D STORAGE TANK DISPOSI'IZON'TRAC-M;G RECORD <br /> #wr..w#w...wra.#wi.#Wf#af.al,1#W##.w#fw#aff#M##Wf###}###1w#fa##tT###i.wM..w.w#1.f#vaa..w/.YsafaWYfW..........a <br /> SECTION 1 -Public IIea h Se:rico Env ron=enral `Iealrh 0h ision Tack TMCI:ng Sheet shall BZ-"o@�Y UCh elk �=d wih <br /> i�sig icon=flcscon nur..be'. 'h.:Tark T-xs-g SAC:is to be ren rad to Public Ha�balder is-Isr:s ble m=31 may^ <br /> w,thin >n ms of aceept="-of the rank by dm disposal or recyciizg faciL'ry. The pe <br /> dtis;oG is c0nz91eted and rerarn d- <br /> ACILT'l N.4`�.: <br /> San Joaquin Countv Mosquito & Vprtnr Contr�i n; ctr; r+ <br /> 200 DI._ Beckman Rd. ' _T —Ai AA Q52A0 <br /> _ FACiLI'iY ADDRESS: J <br /> 01T.UNK SIZE:(00 ?RFI;OUS TANK CON aVTSA� C�I <br /> .#+...•••######+.w.#.r##..�••ia.##*+•a..ar..##W.+.#Miif#v#r#W#>v#w####ifW##fw#/.if##f ............ <br /> SECTION 3-,7a be filled out by=k rema.al conft2cror: <br /> Jim Thorpe Oil , Inc . <br /> Tank removal Con==r. <br /> P.O. Box 357 CIry: Lodi , CA Zip: 95241-0357 <br /> ,bane R: t 2� 368-6175 Daze Tank Re oved: <br /> .i#i.W###War.WW####f##f#f.f#.•H##w.ar.aswww#f###f•'#w.w.#Mi.i.wa++..sari#.................W##faw#........ <br /> SECTION 3 -To be dtled out by contractor"decorttanuaaeing tank": <br /> Tank peccntaaination Can.--aoror: JIm Thorpe Oil , Inc . <br /> .4dd:ess: <br /> P.O. Box 357 C:rrLodi . <br /> 209 368-6175 <br /> ?bone#: (_ <br /> ? <br /> .4ntborMed recrescatative of contractor ca= =g troush sianarare below t.`,t rte taaY:us wmi Cxonrattuaatd _as ae9reved <br /> rnar.w. as t=nired by Cal EPA. <br /> Vice Pres. 5igoaraa: <br /> Hata <br /> Nara.. Martin Thor e Tde: <br /> W#/f/#W#Wi#f#wtW##i.YWf.# .i.wfiOF##....i+w #wWW#WsrYWa#aYlWLWfff##WW+m W##11y#fff##W#Stee` <br /> Pipi'n#qwf�7W �f f 5 do - r Steel <br /> JELTS�N �a �e �� dt � e � g� aera � <br /> aC�'Cpdnl r ad 4w via=°- <br /> Schnitzer Steel Products <br /> Ffl0'''�` �amO1 Rancho Cordova, CA— 95742 <br /> A 12000 Folsom Blvd C'N-- P' <br /> ? one F: t 916 t 985-4810 <br /> Dam Tark Received: <br /> Sage: <br /> T'itic Sig:3'se: Datcf <br /> ....a..#W W..frW#a##a.iii.##ar##.#W#Ww aw.n#aigw...T..•.i.ii..a#a+'lw..'Yi.#.YWWarW#.W#.n#a Jf#waiwf'.W a#f#.lrt.aaaa. <br /> Pae10 <br /> (R.:';iaed C811 3!99) g <br />