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SAN .10nQUIN COUNTY PUBLIC H.ALTH SER' S <br /> ENVIRONMENTAL IIEALTI DIVISION <br /> UNDERGROUND STORAGE TANK DISPOS ION TRACKING RECORD <br /> SFC:'1'1t)N 1 Public Health Services Environmental Health Division Tank Tracking Sheet shall accompany each tank affixed <br /> with its site identification number. The Tank Tracking Sheet is to be returned to Public Health Services Environmental Health <br /> I)ivision within 30 days of acceptance of the rank by the disposal or recycling facility. The perttnit holder is responsible for <br /> ensuring that this form is completed and returned. <br /> FACILITY NAME: Tri Star Homes, LLC ,r.A, # CAC001166584 <br /> FACILITY ADDRESS: 1325 N. Corral Hallow Rd. , Tracy A 95376 <br /> TANK 11) #39 - TANK SiZE: 800 PREVIOUS TANK CONTENTS: ld gasoline <br /> SFc,110N 2 - To be lifted out by tank retnovai contractor: <br /> rank Removal Contractor: Jim Thorpc Oil, ittc. <br /> Adrhess: 351 N. Beckman Rd./P.O. Box 357 Cty: Lodi, CA Zip: 95241-0357 <br /> Phone /!: { 209 ) 3613-6175 Date Tank Removed: <br /> SECTION 3 - To be tilled out by contractor "decontaminating tank": <br /> Tank r)cconrantination Contractor: Jim Thorpe oil, Itic. <br /> Address: 351 N. Beckman ltd./P.O. Box 357 City: Lodi, CA Zip:95241-0357 <br /> Phone b: ( 209 ) 368-6175 <br /> Arnliod7r.d rrprrsrntitive of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> rmnner a,e rcrinircd by CM EPA. n <br /> Name: Title: (�1� Signa re: ate <br /> .� as .aa aa+.++# ++ at #r *##+a#i + *+ ##a#*♦ **####*rr*#### +#### * �*#r#*M •#�*#*AIt*rw**4#Ir�#+1r **#+M#+R� <br /> �`an a is free o a`l}t s urges anyrocari)on vapors Lpon ce )Ver o SChnitZ r, tee . <br /> SFCr'ION 4 - To be signed and dated by an authorized representati7e of a treatment, stotage, or dtsposat actl ty <br /> accepting tank and/or piping. <br /> r'acility Name: Schnitzer Steel Products <br /> Rancho Cordova, CA <br /> Address: 12000 Folsonn Blvd City- zip: 95742 <br /> Phone #: ( 9 16 ? 985-4810 <br /> Date Wank Received: Z <br /> t4'ame: �¢� !�t4 Signature: 17ate �- Gl <br /> �++�*�a*+#***++�++*i#*Yw*#+*+*+##i*###+*+###***##*#+M,k####**###* ##**4#Ir++h+F+►**M*+M��I+MSM+F##F#kkR***+P+U*RIri►M"F <br /> Ell 23 046 (Revised 9/11/96) Page 10 <br />