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SA. JNJOAQULN COUNTY PUBLIC HEALTH SL-&ICES <br /> EN-v RO vtitENTaL 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 sire 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: James King Trust <br /> FACILITY ADDRESS: 541 E. Harding Way, Stockton, CA 95203 <br /> TAMC SIZE: 500 gal. PREVIOUS TANK CONTENTS: Leaded Gasoline <br /> TANK ID X39 - OS/5672 <br /> SECTION 2-To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL, INC. <br /> Address: 677 E. Lockeford St. , P. 0. Box 357 Citv: I nrli _ f.A Zip: 95241-0357 <br /> Phone X: (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: 95241-0357 <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 Y required b Cal EPA. <br /> Mame: 4 /Title o�[� Signature: Date <br /> #z### i##### i } }} <br /> T'an1'k 1s free o a'��is��t ge and ^h�droc rb�n va�grs yKn �1g �Xer 3E� g d el . <br /> SECTION 4 - To be s;gned an .,.e by an an.hnnze re resen a ive o e tr a c, s r ac t <br /> accepting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Rancho Cordova , CA <br /> Address: 12000 Folsom Blvd. City: Zip: 95742 <br /> Phone k: ( 916 ) 985/-4810 <br /> Date ank Received: / '/ <br /> Nar e:V�st/'L1 `fC✓/ Title:_ e�Signature: _ Date `t Uri <br /> 43 <br /> iiiii}###=##i#=i=#i## <br /> EH 23 046 (Revised 08/13199) Page 10 <br />