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SAN J•UIN COUNTY PUDLiC IIEALIII SERVICES <br /> ENVIRONMENPAL IiEALTfi DIVISION <br /> UNDERGROUND STORAGE TANK DiSPOSPPiON 77tACKiNG RECORD <br /> ###4#4a##!!!♦r##!lrraia#aiaFlri+4i4rr#l4Ra#ia♦#♦aaa♦#ai+#r##a+alff4flfif+ff/+•+1•++++111111*1114lIIIIINII♦ <br /> SEt:'I'ION I - pobile Ilenhh Services Fnvhonmemal licaldi Division Tank Tracking Sbeet shall accompany each lank affbted <br /> Wilt III site Idrntiliratoti number. The Tank 'Tracking Sheet Is to be reuuned to iublic Ilealth Services Environmentd Health <br /> I)Ivision within jo days of acreponre of the tank by die disposal or recycling facility. The permit holder is responsible for <br /> eosurbtg that thin form Is completed and returned. <br /> PACILI'i'Y NAME: Van De Pol Enterprises E.P.A. 11 CAC002102104 <br /> I"A(AI,fI Y ADDRFSS: <br /> 3230 N. West Lane , Stockton, CA 95204 <br /> p 10,000 g�JEVIOUS TANK CONTENTS: Diesel Fuel <br /> TANK IU #39 - 0 TANK SIZE: _ e� eL +'(�'4� <br /> rasa4aa#a##i+r4l+r#4#r#a#a!#4iRr##lraM+4i♦4ra!!a#l4farf#44##f4a#4fi#i1a44f++f+f+ 1►11111111111111111111111 <br /> SECIlON I - I be oiled out by lank tetnoyal contractor: <br /> Tmtk Removal Contractor._ Jim "hot'Ue 0111luc. <br /> 5 <br /> Addtess:__351 N. Beckman Rd./( .U. Box 3�7 city: Lodi, CA Zip: 95241-0357 <br /> i'hone #: ( 209_ ) 368-6175 Dere Tank Removed: <br /> t, <br /> aaa#aalav#a#4!ilar##r##arra+a#rairai#!#aalr##aura+a#alaaria4#1#a#+#+#+f4+#f+f+f 1111/+1+1111111111111114111 <br /> SEC'iTON 3 - To be filled out by contractor ,decontandnaling lank": <br /> ?auk Decanuunhtatlon Contractor. Jim Thorpe Mli Iric. <br /> Lo(li CA Zip.95241-0357 <br /> Mldicss: _351 N. Ueckmau Itd./I1.0. Box 35'1City; r P <br /> phone ►: ( 209 ) 368-6175 <br /> Amhothrd teprr-sentadve of contractor certifying through signature below that the tank has been decontaminated In an approved <br /> manner as required by Cal FPA.Milne: r/ <br /> e 1'Itle: �1�, Signature: Dere �a <br /> +1 ariR"�s aF"ree"ofi"a"Yfiral"U"dy'e'd"iaria'1�ya�or'ar'6oii+v+aror+ss ligonaad�etver g o in�It grll ee��111111 <br /> Sr,CT IUN 4 - I'o be signed and dated Ity <br /> ry an aul for re represenla lye of I e treatment, sm e e or spos acll <br /> accepting tank and/or piping. <br /> Facility Narnet Schnitzer Steel Products <br /> Raticho Cordova, CA <br /> Addles.(: 12000 Folsom filed, Cily: Zip: 957 +2 <br /> Phone 916_) 985-4810 f n <br /> Date 1A"kk Receflmeed:_ �`� ^ <br /> name: de: Signature: Date dL <br /> ##+#4+#air++i##aa##4i ##+a#4a#+irria####4i#+ a#sass•#4#afaf#i+arta ++ 4f #a+++ff+f•+111+11II+r11N11111111 <br /> EII 23 040 (Revised 9/11/96) Page 10 <br /> I <br /> ) <br />