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�r(RJD TAMC DISPOSITIONBO <br /> TRACKING RF70pftp <br /> SECTION 1 - The San Joaquin Local Health District's Tracking Sheet will accompany affixed with its site identification n *** <br /> Joaquin Local Health District within 30 d rs of e Tracking Sheet is to be returned to San <br /> recycling facility. Y acceptance of the tank by disposal or <br /> e urin t t 's orae1.1 , le and <br /> m w n,,,,,►,e.. .._._ below is rpQ.�.... �+ <br /> FACILITY NA-E: <br /> FACILITY ADDRESS: /ti T <br /> TANK ID 039- <br /> SECTION - 2 - To be• filled out bY tank removal contractor: <br /> Tank Removal Contractor: <br /> Address: 51 <br /> �O ---------- <br /> r Zi 911 yo _ <br /> Phone tl �e 91 G -�l7r- <br /> Telephone: ( p <br /> Date Tank Removed: <br /> SECTION 3 -To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination" Contractor: <br /> ►'h V d P (� �'A/C— <br /> Address: <br /> v ? E Q <br /> Zip: <br /> Phone#: <br /> Authorized r presentative of contractor certifies by signing <br /> decontami . ppr ` neer as ma below that the tank has been <br /> ' y be regulated by Department of Health Services'. <br /> .r �z <br /> SIGNATURE �� <br /> * *k*** **k******* ******* **************k***A*D*k************k*1t****************X***t**** <br /> SDGTION 9 '`?r"'"' <br /> - To be filled o and signed by an authorized represnetative of the treatment, <br /> storag , or disposal facility accepting tank. <br /> Facility Name SCHNITZER STEEL PRODUCTS CO. <br /> Address: RANCHO CORDOVA, CA 95742 <br /> 916.985.4810 <br /> Zip: <br /> phone#: <br /> Date Tank Received; <br /> 771 -,�OR'Z�E!D� S-qiwxlu?.E AND TITLE <br /> EH 23 049 12/88 ********* <br />'-AILING INSTRUCTIONS: FOLD IN HALF AND STAPLE. AFFIX PROPER POSTAGE. <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ATTN: UNDERGROUND TAMC PROGRAM <br /> P• O. BOX 2009 <br /> ���� ��• CA 95202 , <br /> y <br />