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SEMCO <br /> UJames C. Bateman Petroleum Services, <br /> 1217 South 7th Street, Modesto, CA 95351 <br /> Environmental & General Engineering Contractors <br /> License No. 449564 A, B, C-61/D40 <br /> i <br /> (209) 524-9653 <br /> TANK DISPOSITION TRACKING RECORD <br /> SECTION 1: A Public Health Services Tracking Sheet will accompany each tank affixed with <br /> it's site identification number. The tracking sheet is to be returned to Public Health Services <br /> within thirty days of acceptance of the tank by the disposal or recycling facility. The permit <br /> holder is responsible for ensuring that this form is completed and returned_. <br /> FACILITY NAME: Manteca School District Office <br /> FACILITY ADDRESS: 2901 E. Louise Avenue, Manteca, CA <br /> TANK ID: <br /> TANK DESCRIPTION: 250 gallon diesel <br /> SECTION 2: To be filled out by tank removal contractor. <br /> TANK REMOVAL CONTRACTOR: SEMCO <br /> ADDRESS: 1217 S. 7th Street, Modesto, CA 9535I <br /> PHONE: (209) 524-9653 <br /> DATE TANK REMOVED: 3/18/97 <br /> SECTION 3: To be filled out by contractor decontaminating tank. r. <br /> TANK DECONTAMINATION CONTRACTOR: SEMCO I� <br /> ADDRESS: 1217 S. 7th Street, Modesto, CA 95351 <br /> PHONE: (209) 524-9653 <br /> Authorized repAanproved <br /> ' f contractor certifies by signing below that the tank has been <br /> decontaminatemanner as required by the State Department of HealthServices. <br /> SIGNATURETITLE: <br /> SECTION 4: To be signed and dated by an authorized representative of the treatment, storage, <br /> or disposal facility accepting tank and/or piping,. <br /> FACILITY NAME: Modesto Junk Company <br /> ADDRESS: 1403 9th St. Modesto, CA 95354 <br /> PHONE: (209) 522-1435 <br /> DATE TANK RECEIVED: 3I <br /> SIGNATURE: TITLE: <br /> . P <br />