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PUBW HEALTH SEWICES )4• FPG <br /> SAN JOAQUIN COUNTY <br /> a: I <br /> JW KHANNA kI.D.,MT It <br /> Ilcdlh Olficr • �, (i• <br /> P.U. %x 21x!9 a (1601 East flazelton Avcnuc) a Stockton, Callfurnla 95201 �ifk8d�' <br /> (209) 460-3400 <br /> UNDr0tCItOUND TANK DISPOSITION TRACKING RLCORD <br /> •...•rrrrrrrr•••rrrr••••••r•r•••rr•••r••r••r•rrn•r•••••••r•••••r•••••••.•r•.••••..••••••••••••••••••••••.• <br /> SEG ZION I - Public I lealth Scrvlccs 'Tracking Slice( will accompany each lank affixed with Its site Identification number. 9Tte <br /> 'Tracking Sheel Is Io be relurned h) Public I leallh Services within 30 days of acceptance of the lank by the disposal or recycling <br /> facility. 'I lie permit holder Is responsible for ensuring that this form Is completed and returned. <br /> FACILTI'Y NAME: MOHAMMED MALIK EPA site #��crol,2Y19S15� <br /> FACILFUY ADDRESS: 6550 E. Hwy 12, Lodi , CA 95240 <br /> `TANK 11) M39 . NSA 'Tank Description: 1 - 1000 gal EXEMPT gasoline tank <br /> SECI7oN 2 - To be filled out by lank removal con factor. <br /> 'lank Removal ConUaclor. JIM THORPE OIL, INC. DBA RICII-MART CONSTR. <br /> Address: 351 N. Beckman Rd. , P. 0. Dox 357 City: Lodi , CA ZIP: 95241 -0357 <br /> Phone #: ( 209 ) 368-6175 Date 'Tank Removed: February 13 1997 <br /> •I.rrrrr••••rrrr•••r•rr•rrr•r•r•••r•r•r•rr••rrr•r••••••rr•r•••rr•r•rr••rr•rr••r•••••••r••••••••••••••r••••r i <br /> SECTION 3 . to he filled out by contractor "decontaminating tank": <br /> q'ank Decontamination Contractor: JIM THORPE OIL, INC DBA RICII-MART CONSTR./Nor-Cal Oil , <br /> Ha01er o r nsate <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 City: Lodi , CA Zip: 95241-0357 <br /> Phone d': ( 209 ) 368-6175 <br /> Authorized representative of contractor certified by slgnl g below that the lank has been decontandnaled In an approved <br /> manner as required by the S e Depar lent of Ilealt rvices. <br /> Signature: 77Ue; Vice-President <br /> r• •. •• ... r •. ' . .... ... r••r••r•• . ••r••ri•r upon•• . •very ... . ...•......... .......• <br /> Yank fs tr of a 1 s`Pudges an •hydoulzed vappors upon thdn�lyet, ora Sec�irii zer Stei�� <br /> SECTION A • 'o he sl cd anA dated by an nuthorized epre6eriinOve othe Ireamlent,storage, or d sposal fac y' <br /> acccptl tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. City: Rancho Cordo Zip: 95742 <br /> Phone d': ( 916 ) 985-4810 1 <br /> Vale '1'nnk Received: o� 111 <br /> Signature: Title: <br /> r•,•rr.•r•••••••rr••••••••rr••••rv••u r••••••••.•r•••r••••••••r•r•••rr•rrr•••••r•r•r•r•r•.••••••••••r•••••• <br /> Page 10 <br /> Ea 23 019 (Rev 2/6/91) VP <br /> A bld+lnn o/S+n Jn.gvin C.nunlr Ilollh rare Swicc., l) <br />