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UNDERGROUND STORAGE'TANK DISPOSTTION TRACKING RECORD <br /> **ilii#R#tt*rR#!#tt!#it*#!***#►#tt#i*tit#r#R*tR#tR•Rt#tt##RtR#*R##*!#*#i*#t##R#t*R!###*#'�#*+#++##*'�###R#•*# <br /> SECTION I Public Health Services Tracking Sheet will accompany each tank affixed with its site identification number. <br /> The Tracking Sheet is to be returned to Pubiic Health Services within 30 dAYs of acceptance of the lank by the disposal or <br /> recycling facility. The permit holder is responsible for ensuring that this form is completed and returned. <br /> FACILITY NAME: Bill Reich <br /> FACILI"1Y ADDRESS: '' '540 W. Park Street, Lodi CA 95240 <br /> 350 gallons leaded gasoline & piping <br /> �dj':rv� `8 Tank Descri tion: <br /> TANK ID #39 - � p <br /> SF.t.1'ION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: JIM THORPE OIL, INC. <br /> Address: 351 N. BECKMAN RD. / P.O. BOX 357 City: LOD1 Zip: <br /> 95241-0357-- <br /> Phone #; ( 209 368--6175 Date Tank Removed: 0 <br /> ♦##ltrl Rll#t####♦iR*R##*ERR*#t#*tt###i#tRt#**#i##t#*#*!R#####t##R####tRtrRf*#R#!###*!*it•*##***tt#####**R*# <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: JIM THORPE OIL INC. <br /> Address: P.O. BOX 35 City: LODI Zip: — <br /> 368-61 5 <br /> /1nlltt�tixcd reEtresr.nlative elf conlraclor certifying througil signature below that lite tank has been decontaminated in an <br /> approved manner as required by Cal EPA. <br /> Signature: Title:. PRESIDER. <br /> ♦#R#!!##ri*##+Mr#i*iiR*i#r##R#!!###!R##R#R##**�#RRRY###**r*h##*#R#i####**##*t###ikR#*R+�M**R*R*#'ERR##*##RtoR#*# <br /> T S! t)Np4�n o�eesif c�andfAld b �an driu�ll�air �d Y�3t� ti fit[ ofuf �t�re�al4 , s err L�e��dr �os � il�it r Steel . <br /> accepting tank and/or piping. <br /> Facility Nalue: Schnitzer Steel Products <br /> Address: <br /> 12000 Folsom Blvd City:Rancho Cordova Zip. 95742 <br /> phone #: ( 916 )985-4810 <br /> Date Tanis Received: <br /> Title: <br /> Signature: <br /> ER 23 049 (Revised 7-10.92) Page 10 <br />