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SAN JOAQL-L-; COL. T <br /> Y PUBLIC HEALTH SCES <br /> EN"4-IRO`+-,NLEN-TAL HEALTH DIVISION <br /> U-NDERGROU'yTI) STOPUGE TANK DISPOSITION TRACKS G RECORD <br /> SECTION 1 - Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed with <br /> its site identification number. Tae Tank Trac:ting Sheet is to be returned to Public Health Services Eavirontnental Health Division <br /> within 30 dans of acceptat:ce of the tank by the disposal or recycling raciliry. The permit holder is responsible for ensuring that <br /> this form is coQnieted and returned. <br /> FACILITY NAME: � 5f ��� <br /> FACILITY ADDRESS: <br /> TANK ID #39- <br /> 77rI TAaVK SIZE: �4 PREVIOliS TANK COi�-I'Ev-I S: <br /> �--`- yra=sss=�s3a1*==sal llr=slil=al=axx�rs�tal lc��t3�i'F_3:L.�r r�.ar lr lx +*�=��sr 1p la arxll=al*==xa.s===Mssa<�rss===>ls::=sae ye al=s=tae:yr 111=sx=s it:===xx= <br /> SECTION?-To be tiiled out by tank removal contractor: <br /> Tank Removal Cont;actor. JIM THORPE OIL, INC. <br /> Address: 677 E. Lockeford St. , P. O. Box 357 City:_ 1-n di . CA Zip: 95241-0357 <br /> Phone.7: ( 209 ) 368-6175 Date Tank Removed: <br /> SECTION 3 - To be filled out by contractor "decontaminadn-.tank": <br /> Tank Decontamination Contractor: JIM THORP E OIL INC. <br /> Address: 677 E. Lockeford St. , P. 0. Box 357 City. Lodi , CA Zip: 95241-0357 <br /> P'one n: ( 209 368-6175 <br /> Authorized representative of contractor ce:tirving through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Manse: <br /> Title: Signature: Date <br /> al x><y s= *==xrr al al al al= �e ekial at==gra/al al *=1M al y1=fir Ar�1la.ae*ae==,r1M==*aL rr*:k al=ie ie�*al al at Mr=111**al=rr ar=====xxxxlk=*�=cx�el�. ==as=x <br /> 1*an c i s free off"a�` s udges anc hvdrocarbon vapors yjoentrea dgj�ret,rs�r <br /> SECTION 4-To be signed and dated by an au. hortze represen vapors o , <br /> accenting tank and/or piping. <br /> Facility Name: Schnitzer Steel Products <br /> Rancho Cordova , CA <br /> Address: <br /> 12000 Falsarn Blvd. City: Zin: 95742 <br /> Phone : { 916 ) 985-4810 <br /> Date Tank Received: <br /> Tit1C: Signature: <br /> Name: Dare <br /> >r�==?=====al=1F===xs1=11=a1*ar:M al><x.sssx=====�111e=�1xx r�.=alsrryll ylsxar==ae xlir==x+=i1111sal aexx=al=al====I==al al al x dr a1==r=?==ax==xl:ya< <br /> EH 23 046 (Revised 08113!99) Page 10 <br />