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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> SI1'E NUNv1BER .10 <br /> SECTION 1 -Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br /> with its-site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health <br /> Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for <br /> ensuring that this form is completed and returned. <br /> FACILITY NAME: PORT OF S11=N EPA #CAL 000041551 <br /> FACILITY ADDRESS: 2201 WEST.' WASHINGTON STRE;E'P, SIMCION, CA 95203 <br /> /1 250-1000 G GASOLINE <br /> TANK ID n39 - � � 1 C� TANK SIZE: PREVIOUS TANK CONTENTS: <br /> SECTION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: -JIM THORPE OIL, INC: <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 Ciry: Lodi , CA Zip: 95241-0357 <br /> Phone : 2( 09 ) 368-6175 Date Tank Removed: Jan 5, 1999 <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: JIM THORPE OIL, INC. <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 City: Lodi , CA Zip: 95241-0357 <br /> Phone r: 2( O9 ) 368-617x <br /> Authorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Name: Martin Thorpe # Title: V P Signaturetm._ ,¢mare 1/4/99 <br /> ## ##### C�a t#kty###################i###############i#i######i#i################iii#####i# <br /> '*'aV is ire@ o a 1 s e and h&dr1(Ng �$r vgap�rs tyg dive � $ bS�f�r�it �t�el . <br /> SECTION 4 -To be signed an a e b an au or3 r r en ve o e rea ent, ram t po acr t <br /> accepting tank and/or piping. <br /> Facility Name: SCHNITZER STEEL PRODUCTS <br /> Rancho Cordova, CA <br /> Address: 12000 Folsom Blvd. City: Zip: 95742 <br /> Phone#: <br /> Date TankReceived: (� g / f <br /> Name: bow (�6r-rn'e Title: Q/ t�Sre� Signature: Date G �i <br /> EH 23 046 (Revised 9/11/96) Page 104- <br />