Laserfiche WebLink
1 . <br /> UNDERGROUND STORAGE TANK DISPOSMON TRACIaNG RECORD <br /> rwrr►rraaarR�YrtYarYaRarsRaaYRariYaa+IratYaia#i►salsrrrs4aritlrr►rwrsrYr►►►rsrM4yRrRRYYar►alYa4rw4s4a4wassYrr <br /> SECTION 1 • Public fieatth Sotvias TracWng 31tset will accompany each tank affbad with its site identification mmtber. <br /> 'Me IzWldng Sheet is to be n%wncd to Pnlilie liealth Sit.�of aampuuuz of the teak by the diapow or <br /> meyding fiaadiity. The permit balder is respoasibie fix earning that this brat is completed and returned. <br /> FACn=NAMS: PIEDMONT LIMBER S MILL CO.,INC. <br /> FACILrTY ADDRES&. 7777 WEST ELEVENTH STREET, TRACY, CALIFORNIA 95376 <br /> TANK ID #39. d NoZ Tani Uacxiptioa_ ;SO GALI.MI �,�e12LIhtF <br /> - iaYYRala■aarrarar srsrP rr rrsaaaaaiaaaR YrraaYraaaRaaf ri.rq ssrr NrrssNrar userassYYaRYiisRRa lsisrrralrlaaaaa <br /> SECTION 2-To be filled out by tm k removal wntz2ctor: <br /> Tastlk R=toval Contractor: 'Ab= iiP18LITZJ � <br /> ,drag:BOX 30331 City; STOCKrTCN Zip: 95213 <br /> phone#: ( _209__) 943 7793 Date Tank Removed: Q �f V�-' _q,4 <br /> +rasssissrrr■rrrsrssaaaaslssiaastasraaiarraaratrru4srsrRsaaaaaslaarasraswrr was <br /> srrrsssrrarsssssisrasssarssr <br /> SECTION 3-To be Bled out by conu=w teak': <br /> Taut SAME AS SECTION 2 ABOVE <br /> Addr=- City.-zip: <br /> Phone #: <br /> AuMotirad representative of coau2mr certWng through signature below that the tunic has been decontaminated in all <br /> approwd manner as required by Cal EPA <br /> Signature: Tltic: <br /> rssrriaai�rarasrrsrlsYa• raaar!!sr ♦rrsrr. ►rrrsarrrrlaRRYlYRRYaiararlri{aairraalaaalasasa4araat <br /> SECTION 4 -To be sipW and load by an aur tattve of the treatment,swinge,or disposal facility <br /> accepting tank awft pipes <br /> Facility Name; CAL COAST TAMC MFG. <br /> Address: 424 S. TEG ER R= Qtr. TURV&K Zip: 9 5 381 <br /> Fhone#: ( 209 ) 668 9378 <br /> Date A" ,4Y U <br /> S. <br /> I-& <br /> tartrrraalRaararrr4rrrr►rtrf+tar►sa►aaYa1/YrrataaraaararYYArlsai 4lerasaaf►aA�waairs►+� <br /> 0 23 049 cttsvised 7-10-9Y) rpe FOURTEEN <br /> r <br />