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SAN JOAQUrNi COGNTY PLBLIC HEALTH SERVICES <br />EN-VIRON-NIENTAL HEALTH DIVISION <br />UNDERGROLti-D STORAGE TANK DISPOSITION TRACKING RECORD <br />....iiiii#ZZZ#iiiii##ZZZZ......Z#Z##ZZZ#ZZ#ZZ#i#Zai##Z#Ziiiiia##Ziii..................iiiiiii#...a <br />SECTION 1- Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each rank affixed wir- <br />its site identification number. The Tank Tracking Sheet is cc be retuned to Public Health Services Environmental Health Divisiec <br />Within 30 days of acceptance of the tank by the disposal or recycling faciiirr. The permit holder is responsibie for ensuringthat <br />this fora is compieced and returned. <br />FACILITY NA.IE: Cancun Restaurant Parkinz Lot <br />FACILITYADDRESS: 342 N Hunter, Stockton, CA 95202 <br />TANK ID.;?9 - TANK SIZE: `r�350 PREVIOUS T NK CONTENTS: j Pa rjArj Qq i <br />####ii#i##ZZ......Zz#ZZZ#Z#zii#z## Zi.........iii#i ...... <br />SECTION 3 - To be tilled our by tank removal contractor: <br />Tank Removal Contractor: JIM THORPE OIL, INC. <br />Address: 677 E. Lockeford St., P. 0. Box 357 Circ: Lodi . CA Zip: 95241-0357 <br />Phone .': ( 209 ) 368-6175 Date Tank Removed: <br />##iiiii##ii#i##i########Ziii#iaaa#i####ii#aii###i##i#iaai.......iiiii##iiiii##i#iiia............iiia.>aazaa <br />SECTION 3 - To be filled out by contractor "decontaminating tank": <br />Tank Decontamination Contractor: JIM THORPE OIL INC. <br />Address: 677 E <br />Phone .r: ( 209 ) <br />Lockeford St <br />368-6175 <br />P. 0. Box 357 City: Lodi. CA Zip: 95241-0357 <br />Authorized representative of contractor certifying through signature below ;hat the tank has been decontaminated in an approved- ., <br />manner as required by Cal EPA. <br />Name: <br />Signature: Date <br />be signedSaTndddaed by an au2horiizea cepresen�age of on_e [mope brQq.;FgPs��s P ac�iiel . <br />e ea . c, s <br />accepting tank and/or piping. <br />Faciiiry Name: Schnitzer Steel Products <br />Rancho Cordova, CA <br />,address, 12000 Folsom Blvd. Carr Zio: 95742 <br />Phone R: ( 916 985-4810 <br />Date Tank <br />Name: <br />Tide: Signature: Date <br />....i.aii.....ai..i.....Z#i.#ii.ai..........ai#.aa.#iii.aiaiiaa.aa....a..a.................:..:.ii........ <br />EH -3 0,+6 (Reused 08/ li/99) Pate 10 <br />