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PUBW HEAffH SRWICES .. <br /> SAN JOAQUIN COUNIY t� <br /> a; l <br /> 1061 KIIANNA M.D.,M.P.11 <br /> Hol(hOffiar i (� <br /> P.O. Nx 2009 • (1601 East IlAzclton A)Tnuc) • Stockton, Gllhxnla 95201 <br /> dkl�dA� <br /> (209) 460-3400 <br /> UNDLRGIIOUND TANK DISPOSITION TRACKING RECORD <br /> •.r••••rr•••••r•••rr••r•rrr••••rrrr•••r•••••••••••••••••••••r••••••••••u••••••••••u•r•••••••••••••••••••• <br /> SECIlON I - public I lealllr Services Tracking,Slice[ will accompalry each lank affixed with hs she idenllRcallun number. The <br /> 'I larking Sheel Is to he returned to Public I Icallb Service-%wifldn 30 dnn of acceptance of the lank by the disposal or recycling <br /> facility. The penult holder Is responsible for ensuring that this for is completed and returned. <br /> FACILITY NAME: ROBERT G. HOWEN EPA SITE #CAC 000764248 <br /> FACIL.IIY ADDRESS: 251 Ticknor Ct. , Lodi , CA 95242 <br /> TANK 11) #39 • N/A 'Tank Description: 1 EXEMPT 750 gallon heating oil tank <br /> SIiC'll6tI 2 - To be filled out by lank removal contractor: <br /> 'Innk Removal Contractor: JIM THORPE OIL, INC. DBA RICII-MART CONSTR. <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 City; Lodi , CA Zip; 95241 -0357 <br /> Phnne Y: ( 209 ) 368-6175 Date Tank Removed: 10/9/96 <br /> •• .a r•u•••••••r•rr••••••••r•••r•rr.•r•r••rr•••r•••••••ru r•••r•••••••••••••••••••••••••r•••••••••••••••• <br /> SECTION .1 - to be filled out by contractor "deconlandnating link": <br /> 'lank Dcconlanrination Contractor: JIM THORPE OIL, INC. DBA RICII-MART CONSTR./Nor-Cal OiII <br /> Hauler of r)nsate <br /> Address: 351 N. Beckman .Rd. , 1'. 0. Box 357 City; Lodi , CA Zip: 95241-0357 <br /> Phone d: ( 209 ) 368-6175 <br /> Authorized replesentallve of contractor certified by signing below that the tank has been decontamhtaled In an approved <br /> manner as required by the Slate Deparunent of lleahh Services. , <br /> Signature: CP �zce�L/��hA — THTC: VAU-President <br /> V <br /> Tank )s #Yee Wallsluff es an( �I) drocarVon va )ors upon dgliver to �cFui tzer Stfle� . <br /> SECI ION 4 - '1'o he signed and dated by aauthorized represultntive o�lite treaoncntystorage, or d <br /> n isposal faclllty <br /> accepting lank and7or piping. <br /> racllfty Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. City: Rancho Cordo Zip: 95742 <br /> Phone If: ( 916 ) 985-4810 <br /> Date 'lank Received: <br /> Signature: 42 i7nbvTitle: <br /> Page 10 <br /> Ea 23 0.9 (Rev 2/a/91) W <br /> ' A Uidtlnn of$.n)Nuala f:mmlr Ilallh Urt$cMttl <br /> �� <br />