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. <br /> PUBU,L p. <br /> HEALTH SE'113�'�T.T.CES <br /> SAN JOAQUIN COUNTY <br /> i IMI KHANNA M.D.,M.P.H. T <br /> ilraith Ullitcr 0�106,��'� <br /> Rox 2009 0 (1601 East Itazclton Avenue) • Stockton, CA1110 nla 95261 <br /> (2o9) 468.3400 <br /> UNDrAt(:RUUND I'ANK DISMS11.1" TRACKING RECO R" <br /> ••••••••••••••••••••••••,•••,••••••••••••e•••e••••••••••!••••h tank arrixed with Its site Identification fnumber.•The <br /> Sf�:11Olf I P+1111#c 1Ica11h Services 1'racking S11cc1 will accompany cac <br /> r'rackin Sheet is 1n hTPIRMCC <br /> e returnecl tp I'uhlic 1 lcai111 Services within 3l1 dais fLa d returnedof the k by the disposal or recycling <br /> facllily. lrtte permit !older Is responsibic for ensuring that this formcompleted <br /> F11C1LIi'Y NAME: Boettcher Western Pro erties 1 Ltd. <br /> 4555 N. Pershing Ave. Stockton, Calif. <br /> 1'J1CILI11 AUI)RCSS: - <br /> t'?E_ Tank Ucscripti(1n: 12,000 gal. Unleaded Gasoline <br /> 'I'ANK IU N39 - l-_ g Q4q <br /> >=PR Site # CA 0 <br /> .r.rrrrrrrrl•rrrrrrrrrrrrrrrrrrr•rrrr•rrrrr►rr H••r••e•r*•..••••.♦ • •f r• N•fff!•!•!!f!!•••f••1!!• <br /> S�(.iir)N 2 1'p he flllerl pill by i ik 7}nvaj contractor <br /> INC. DBA RICH-MART CONSTR. <br /> Tao+k Removal Contractor: CA Zi : 95241-0357 <br /> Address: 351 N. Beckman Rd. , <br /> P. U. Box 357 City: Lodi , p <br /> Phone #: ( 209 ) 368-6175 Date 'rank Removed: <br /> ,.r.rr..r►rrrrrrrr•rr•••rrrrrrrr••rrrrr•rr•rrr••r•••rr*!•!•r•*•!•!!r•!!!!!!!R!•!!R!!!f!!!!!!!!!!!!!!!!!!f!! <br /> SI ['1 inN i <br /> It, he filled 0111 kiy c011ttactor '(Icconinminnting tank'. <br /> Tank Decnntantinalion Contractor: JIM Tit0RP1r OIt ING. DBA RICK-MART CONSTR. Haulerlofirinsate <br /> Address: <br /> 351 N. Beckman �Rd. , P. 0. Box 357 City: Lodi , CA Zip: . 95241-0357 <br /> phnne 368-6175 <br /> Atilbrif0ed represen+ative of cpntractpr certified by signing bw that the lank has been decontaminated in an Approved <br /> manner as tcquircd by the State Department of I Iealth Services <br /> Title: ,.Vice-President <br /> Slgnalmr: <br /> Tank is free of all sludges and hydrocarbon vapors upon delivery to Schnitzer Steel. <br /> ►i••••••••••••• •••••••••••••,..r.rrrrrrrr.r•••r•rrrr.....ve o[ the treatment, storage, or disposal facility <br /> «*••*• <br /> SECT IVN 4 - 'T'p he signed and talcd by an nrtthurized represen <br /> accepting tank andlor piping. <br /> Facility Name: Schnitzer Steel Products <br /> Address: <br /> 12000 Folsom Blvd. City: Rancho Cordov Zip: 95742 <br /> Phone (__116 ) 985-4810 <br /> Date 1'ank Received: <br /> Title: <br /> Signature: <br /> •....rr.r.rrrrr•r.r.r••r•rrrr.r•r.srrrr.rrrrrrrs.r•rr•rrr••r••••••r•1!r•rr••••••r••••r•••••♦H••♦!ff•f••rr <br /> Page 10 <br /> EN 23 049 (Rev 218/91) vp <br /> A DM51nn of Smn)nrrottlrt Cnumr Iffs"Core scrAcc., <br /> J. <br /> S <br />