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PUB HEALTH SET'JICES <br /> SAN IOAQUIN COUNI-Y <br /> p-A KHANNA M.D., M.P.H. <br /> Heahh Officer � 1i 'd 'd� � <br /> P.O. Box 2009 ( IG01 Eut Dazciron Avcnuc) • Stockton, (GJIlomla 95201 <br /> ( 209 ) 468-3400 <br /> UNUERGIfOUpfU TANK DISI.OSITION TRACKING RECORD <br /> • . • • . • • • . • • • . • . • • • r • • • • • • • • • r • • • • • • • r • ra r • • • • • • • r • • • • • • • • • • • • • • • r • • r • • • • • r • • • Hr • rron numbers <br /> Ti • <br /> SFG Tli ION I - Public I f retrune I vices Tracking to Public I Ical Irl Services within r J0 days of acceptance of the taneet will accompany cach lank affixed with Its sit <br /> ices <br /> the Disposal or recyclng <br /> acking Sheet is In <br /> facility. lbe penult holder Is responsible for ensuring that tills form is completed and returned. <br /> FACILI"I Y NAME: <br /> Barnes Trucking <br /> FACILITY ADDRESS: 1817 S . Fresno Ave . Stockton Ca . 206 <br /> 10 , 000 gal . diesel fuel <br /> Tank Description: ��� <br /> 'TANK IU # 39 - �i5a6 '� °� i EPA Site G /� �`� <br /> SF.CI'►ON 2 - TO be filled out by tn��l4reTIlORPmoval E OIL , oINC . DDA RICH - MART CONSTR . <br /> 'Tank Removal Contractor : Lodi , cn zip: 95241 - 0357 <br /> Addtes.v: 351 N . Beckman Rd . , P . 0 , Dox 357 City: <br /> Phone # : ( 209 ) 368 - 6175 Date Tank Removed: <br /> • • • • • • • r • • • rrrr • • r • • • • • • r ♦ • , • • , • r • • r • • • • • • • r • r • r • • • • rr • r • • r • • r • • r • rr • • • • • r • • H • . •1 • N • • rN •i • • • • • H • • • r • r • • <br /> SECTION 7 - <br /> to be filled out by contractor "decontaminating lank": <br /> Hauler of rinsate <br /> 'Tank Decontamination Contractor: JIM THORPE OIL INC . DDn RICH - MART CONSTR . /Nor - Cal 0 <br /> Lodi , CA Zip: 95241 - 0357 <br /> Address: 351 N . Beckman Rd , , P . 0 . Dox 357 City: <br /> Phone # : ( 2U9 ) 368 - 6175 <br /> Aathorized representative of contractor certifled by signing below that the tank has been Jeconlaminated In an approved <br /> manner as required by the State Department of f lealth Services. <br /> Title: Vice - President <br /> Signature: <br /> Tank is free �of• a � l � sludges and• h �� � rocarbonapors upon delivery <br /> to Schnitzer tee <br /> SECTION 4 - •To •be signed and dated by an nntlmrized ,representative of tire treatment, storage, or disposal facility <br /> accepting lank and7or piping. , <br /> Facility Name: Schnitzer Steel Products <br /> 12000 Folsom Blvd * <br /> City: Rancho Cordova Zip: 95742 <br /> Address: <br /> Phone N : 916 ) 985 - 4810 <br /> Date Tank Received : � Z <br /> Title: <br /> Signature. <br /> Page 10 <br /> \\ EN 27 o69 ( Rey 2/9/91 ) wP <br /> A w ionn or Sin )n.miln Cm ty neahh Care Senic<� <br />