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l_ Q <br /> P U B L <br /> L), HEALTH SCES <br /> E <br /> SAN JOAQUIN COUNTY _{ <br /> JOGI KIIANNA M.U.,M.P.H. <br /> P.U. fl6x 2()t19 • (Ib()1 East ffaztlton Avenue) • Stockton.Callfonnls 95201 <br /> (209) 46R.3400 <br /> UNUI;It(GIt0UNI) TANK UISIa0Sl1'I1UN TRACKING RECORD <br /> •�•••••••••••*•••••••••••••• •••fR.1aR•1RR1aR1#IR••••IRM#11cftlank affixed with <br /> ItssiteIdentificationnumber.IThe <br /> Sf±C.1'IUN 1 I'nblic I fcaIII, Services TrackfnR Shcct will accompany ca <br /> - Arkin Sheet Is In he rclllrnccl ur ruhlic Ile, Services within 3(1 dny3 Of acceptance <br /> Of the <br /> by tile disposal or recycling <br /> l r. <br /> 'king <br /> facfl#ty. 1 he permit holder Is responsfbie for ensuring that this forms p <br /> FACILI-I*Y NAME: Boettcher Western Pro erties 11. Ltd <br /> 4555 N. Pershing Ave. Stockton, Calif. <br /> FACIi,ITY ADDRESS: <br /> !� ? `? Tank Description: 12,000 gal. Gln <br /> 'TANK IU x'39 • EPA Site � CACI t�QOf���Q4Q <br /> ....,...•.a...............................R....•/....•....•.IR/./1 1 1. •. .....•.111«.1.«11.11.«««..+ <br /> Sr(�I'1C)N 7. �b be ffflelf oul by tank removal contractor: <br /> 1'nnk Removal Cvrrtracti)r: JIM THORPE OIL, INC. DBA RICH-MART CONSTR. . <br /> Lodi , CA Zip: 95241-0357 <br /> /ldclress: 351 N. Beckman Rd. , P. 0. Box 357 City: ; <br /> Phone 0: (___209 368-6175 Date'}'ank Removed: <br /> „�,a,,,�...1a1►raa♦aa1Rs.••f1•R•1•fRa/fRa•IR•IRR#•R111.1,..«1111.111«I«!#lN11l1«111+«•!/!!/«!«««!«!!!..«« <br /> S1 C1ION to he. filled trot I?'y contractor "deco ntarninating lank': Ilauler 0€ rin5ate <br /> Tank Ucconiamination Contractor: J[M TIIORPE OIL INC. DBA RIC}}-MART CONSTR. Nor-Cal Oil <br /> Address: 351 N. Beckman Rd. , P. 0. Box 357 City: <br /> Lodi , CA Zip: 95241-0357 <br /> Phone #: ( 209 ) 368-6175 <br /> k has been decontaminated in an approved <br /> Anthrrrlr.ed represenl:ltive of contractor certified by signfng bclow that the lan <br /> manna as teluired by the Slate Deparinicnt of Health Services. <br /> Title: Vice-President <br /> Signalltre: <br /> Tank is free of all sludges and hydrocarbon vapors upon deliveriy to Schnitzer.Steel;..... <br /> `.aaaffafa•111af,aa,•a1fRfRaf•faffaaafaal•a+•1f•R11 R111R11//•1•R1•RR•11e1••#/ •#++111#11111111R#1111 �11R1/ <br /> SECTION 4 - I'o Ire signal and dated by an nuthorized representntive of the treatment, storage, or d6posal facility <br /> acceptfr►g lank andlor piping. <br /> ocillly Nance: Schnitzer Steel Products <br /> Address: <br /> 12000 Folsom Blvd. City: Rancho Cordon Zlp: 95742 <br /> rhone 9: ( 916 } 985-4810 <br /> Date 1'ank Rcccivcd: <br /> Title: <br /> Sigrin t+rrc. <br /> •.1.•a•i.1...1....1.faaala affrfafafaa ffa1a 1/R1•flaaf Ra if 1RR11 Rt•RRR N R1R•1R•I IRR11.11•IR1/R1/#.«111#.1.1 R• <br /> Page 10 <br /> EH 23 040 (Rev 2/9/91) WP <br /> A VM1106 or San Jnagriln County 11-11h Cart 5trvicc+ , <br />