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E32UV JDA:UIDJ LOCAL HFEAT.T4DTSTRICT <br /> UNDERGROUND TANK DISPOSITION TRACKING RECORD <br /> xx*zxxzx*zk*zxz*xxzxrzxxzxxxxxxzxzzxxxxxxxzxxxxx**xxxxxxxxxxxxxxx*zxzzxzxzzxxz****x*xxxxxxx <br /> SECTION 1 - The San Joaquin Local Health District's Tracking Sheet will accompany each tank <br /> affixed with its site identification number. The Tracking Sheet is to be returned to San <br /> Joaquin Local Health District within 30 days of acceptance of the tank by disposal or <br /> recycling facility. The holder Of the permit with nQM!?29 <br /> ensuring that this form is completed and returned L Noted below is responsible for <br /> FACILITY NAME: QUINTERO'S AUTO DISMAPJTLING <br /> FACILITY ADDRESS: 2966 Turnpike Road, Stockton, CA V J <br /> _ /S <br /> TANK <br /> zz°x#** �zxxxxxx*x**xz***z**xxrxxx10100 aaltontxtank <br /> xxxEPA <br /> sr*xxx*xzxxx**�t� a/S <br /> SECTION - 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Tank removed by owner <br /> Address: <br /> Zip: <br /> Phone#: <br /> un orpe Oi triple rinsed & <br /> Telephone: ( ) Date Tank Removed: n4mown picked up tank 5/15/90) <br /> xxzzzzxzzxzzzxzxzzxzzxxzzxxzx**********x******xxzxxzxxzxxxxzxzxzxzzxx **xzzzzzxzxzzxzzxzz <br /> SECTION 3 -To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination" Contractor: JIM THORPE OIL, INC./Nor-Cal Oil , Hauler or rinsate <br /> Address: 351 N. Beckman Road, Lodi , CA Zip: 95240 <br /> Phone#: (209 368-6175 <br /> Authorized representative of contractor certifies by signing below that the tank has been <br /> decontaminated in an approved manner as may be regulated by Department of Health Services. <br /> Vice-President <br /> SI AAND TITLE <br /> xzxxxzxxzxxzxxzxzxxxxxxxzxxxzxzzxzzzxxzxxzxzzxxxxxxxxxx*xzz*xx*x*xx***xx*z***xzxzzxxzxxxxzx <br /> SECTION 4 - To be filled out and signed by an authorized represnetative of the treatment, <br /> storage, or disposal facility accepting tank, <br /> Facility Name Schnitzer Steel Products <br /> Address: 2000 Folsom Blvd. , Rancho Cordova CA 974 Zip: <br /> �/ Phone#: (916) 985-4810 <br /> Date Tank Received: �/� pU <br /> AUTHOR ZED SIGNATURE AND TI <br /> **zzxzzzxxzxz*zxzz*xx**z*x********x***zxxzxxzxxxxxxzx*zz*z*****x*************x*xxzxxxxxxxzx <br /> EH 13 049 12188 <br /> MAILING INSTRUCTIONS: FOLD IN HALF AND STAPLE, AFFIX PROPER POSTAGE. <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ATIN: UNDERGROUND TANK PROGRAM <br /> P. 0. BOX 2009 <br /> STOCKTON, CA 95202 <br />