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SAN J AO QUIN COUNTY PUBLIC IIEALTII SERVES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> UNDERGROUND STORAGE TANK DISPOSITION TRACKING RECORD <br /> tittit+###t+#t###t#tt##t###t##t#######«*#######tt###«ttt#t##tt#*#+r##+Y##««###«#F#«#««M#«f�#JR4•#�4�4•*#*#tM M# <br /> Sf t 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 llealth Services Environmental Health <br /> Division within 30 days of acceptance of the tank by the disposal or recycling facility. The permit holder is responsible for <br /> ensuring that this form is completed and returned. <br /> FACILITY NAME: American Transfer Company E.P.A. # CAC 001415264 <br /> FACILI'T'Y ADDRESS:2701 Highway 99 South, Stockton, CA 95215 <br /> TANK ID #39 - 1�L�-� TANK SIZE: d PREVIOUS TANK CONTENTS: Diesel Fuel <br /> aitt+#+t+it�t+t##t#tt#*#***###*««*##t##***##t#*«*##+r+##*#«+r*+R#####+#####«««#*«#«#««#««+*«#44R44#«**+A«**#**• <br /> SEC'T'ION 2 - To be filled out by tank removal contractor: <br /> Tank Removal Contractor: Jim Thorpe Oil, Inc <br /> Address: 351 N. Beckman Rd./P.O. Box 357 City: Lodi, CA Zip: 95241-0357 <br /> Phone a: ( 20_) 368-6175 Date Tank Removed: <br /> r++**+#i+*•*+t##t*+ttt*t*##*«*t*t#t##*tt###*#t«#tt*########ttt#««##«#«#*##«#�«##**#««#444*#44#�44**44444444 <br /> SECTION 3 - To be filled out by contractor "decontaminating tank": <br /> Tank Decontamination Contractor: Jim Thorpe Oil, Inc. <br /> Address: 351 N. Beckman Rd./P.O. Box 357 City: Lodi, CA ZIp:95241-0357 <br /> Phone #: ( 209 ) 368-6175 <br /> Amhorized representative of contractor certifying through signature below that the tank has been decontaminated in an approved <br /> manner as required by Cal EPA. <br /> Nance: Title: Signature: Date <br /> tY'ari�C+i s tf*ree`o *aYt«'s1 ulg'e#s«ani`1�«y* 'rocar6on«v«apor«s'upon'"deli very' o 'cd`hni t r'. tee ******* <br /> SECTION 4 - To be signed and dated by an authorized representative of the treatment, storage, or tspc <br /> os atl ty <br /> accepting tank and/or piping. <br /> Facility Name: Sciulitzer Steel Products <br /> Rancho Cordova, CA <br /> Address: 12000 Folsom Blvd. City: Zip: 95742 <br /> Phone a: ( 916 ) 985-4810 <br /> Date Tank Received: <br /> Nance: Title: Signature: Date <br /> Ell 23 046 (Revised 9/11/96) Page 10 <br />