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SANJOAQUIN COUNTY �' 1 1L <br /> J(x;l KIIANNA Mb.,1•LP II. ( � <br /> IWith 011ier `� <br /> CO. Mix 2(109 • (M,01 F.a t llazelron A•cnue) • Stockton, Gllfi rn6 95201 4Zlk8A't <br /> (2o9) 46934o <br /> UNDrItUROUND TANK DISPOSITION TRACKING 11ECORD <br /> r••••r•rr•••rr•r•rr•r•••••••r•r••rr•••rr••••r•••••r•r•r•••••rr•••••••r•u•••••••••••••••••••••••••••••••••• <br /> SF(:I1DN 1 - Public I leallh Services 'I'rncking Shcel will accompany each lank affixed with its she Idenli8cation number. The <br /> 'Barking Sheet Is In he returned to Public I Icalth Services n101111 30 d3 of acceptance of the lank by the disposal or recycling <br /> facility. -lite permit holder Is responsible for ensuring that this form Is completed and returned. <br /> FACILITY NAME: DART CONTAINER EPA SITE #CAD 981964489 <br /> FACILIIYADDRESS: 1400 E. Victor Road, Lodi , CA 95240 <br /> 'TANK ID #39 - Tank DcscripUon: 1 - 550 gallon gasoline tank & piping <br /> SVC`II )N 2 - to be filled out by lank removal contractor: <br /> 'lank Removal Contractor: JIM THORPE OIL, INC. DBA RICII-MART CONSTR. <br /> Address: 351 N. Beckman Rd. , 11. 0. Dox 357 City: Lodi , CA Zip: 95241-0357 <br /> Phone p: ( 209 ) 368-6175 Date lank Removed: 11/4/94 <br /> ••r•r•rr••••r••••r•r•••••r•••r••••••r•rrr•r••••••r••r•r••••••••••r•••••••••••••••••••••••.••••••••.•••••••• <br /> I <br /> SrC1ION 3 - to he filled oul by contractor 'decontaminating Innk": <br /> lank Decontamination Contractor: JIM THORPE OIL, INC. DBA RICH-MART CONSTR./Nor-Cal Oil1 <br /> Hauler of rtnsate <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 Cpy: Lodi , CA Zip: 95241 -0357 <br /> Phone rl: ( 209 1 368-6175 <br /> Authorized representative of contractor cerllfled by signblg below that lite lank has been decontaminated lit an approved <br /> ntnnner as required by the Slate Department of Ilenith Services. <br /> Signature: ckn -4,p— ffUe: Vice-President <br /> . •• r•,•• ••,••r rr •u . ••a'an <br /> ly rocar on <br /> r•• r•r•va or••rr• n . ivery. o • riAze••••••r •••••.•. <br /> rank is tree off' gne sludges by <br /> uthoriediep va�lors uPlIl dGJtvet, of St, oriidspos Stell . <br /> SGC IlON 4 • 'I'o he signed and dated by an authorized rcpreser Intive u the treatment, storage, or sposal Fac 11y <br /> accepting lank and/or piping. <br /> facliily Name: Schnitzer Steel Products <br /> Address: 12000 Folsom Blvd. City: Rancho Cordoy5tip: 95742 <br /> Phone A': ( 916 ) 985-4810 <br /> Dale lank Received: <br /> Signature: Thle: <br /> Page 10 <br /> ra 23 069 (Rev 2/a/91) up <br /> , A Uld.ann dS+n fmquln Cmmn Ilohh Ora Sanlcce <br /> C) <br />