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SERVICESPU�I,� ., HEALTH �s <br /> t <br /> ' SAN JOAQUIN COUNTY w; <br /> J061 KHANNA hl 1),M P If •. <br /> Ilt�llh Ufflcer � <br /> P0 Box 21)119 • (1601 East Ilarclton Avenue) • Stockton, California 95201 <br /> (log) 469 3400 <br /> UNDERGROUND TANK DISPOSIIION TRACKING RECORD <br /> ' .•.•srr••1111111••r•••••r•s•••srr•r•srs•••••sirs•sr•rs••rrssssr•r•r•••ssss*••rr.srsssfrlarfr..rs.sl.f!!r!f• <br /> SM.'I ION 1 - Public I(caltlt SetviCeS 1 racking Shect will accompany each tank affixed with Its site Identification number. The <br /> I racking Sheet 11 to be returned to Public I ienllh Services willdu 30 da a of acceptance of the tank by the disposal or recycling <br /> ' facility The permll holder I% responsible rut ensuring that tills form Is completed and returned <br /> CIIGILII Y NAME Sierra Bay Farm Credit <br /> ' <br /> F-M-ILI I Y ADDRESS 18775 Tom Paine Road, Tracy, CA <br /> ' I ANK 11) #39 - �3 67-01 '1 ank Vescriptlun• aJJl <br /> .•.•.•1•rrrrr••r•r•►r••••r•••11rrr••••••••t••rr•rr*too Si`e rr�CA;r00062#:84.•ff!••••!!!•.!f!!•.f!•!!: <br /> lank RN 2 - To o tract out by 1 JtIMremoval THORPEoOIL , INC. DBA RICH-MART CONSTR. <br /> lank Removal Contractor: � <br /> 351 N. Beckman Rd. , P. 0. Box 357 City. Lodi , CA Zip: 95241 -0357 <br /> ' AddreSti• �7 <br /> phone M ( 209. ) 368-6175 Date lank Removed: <br /> W6$0$of•r•1�#04.f••1111•••r•♦f•Rrrr••rrr•r•rsssrs•rr�l•r••rf•rrr!•sfr!!••t!!!f!f!f!f!flrrlf!!!!H 1!1!1!!1• <br /> ` Cl ION 3 - In be filled out �y contractQr "deconlaminnting tank": Nor-Cal Oil <br /> lank f)CCr)nlarnlnalh111 Contractor• JIM THORPE OIL 1NC. UBA R1CI1-MART C�NSTR• Hauler of r nsate <br /> Address <br /> 351 N. Beckman Rd. , P. 0. Box 357 City Lodi , CA Zip: 95241-0357 <br /> ' Phone #. ( 209 ) 368-6175 <br /> Arrthnrlied representative of contractor cerr#ficd Icy signing below that the tank has been decontaminated in an approved <br /> manner m tequlred by the State Department of Ilealth Services <br /> /1.f .,,(le. Vice-President <br /> Slgn:ttutc: � � <br /> Tank is free of all sludges and hydrocarbon va ors upon delivery to Schnitzer Ste�� <br /> r••rr•r••sssrr••s•sr•rs••••srss•r•r•rrrr•••+•..sslrssls• 1st1lssrsrsrrttos1. 111s111f1t11s1ssrsll• i11f1! <br /> SoECI ON 4 - 3o he slgnctl and dated by an nuthorlaed rtpresentative of the treatment,storage, or disposal facility <br /> acceptin tank and/or iping <br /> facility Name: Schnitzer Steel Products <br /> ' <br /> Addre.53' 12000 Folsom Blvd. Cit Ra <br /> city. Cordova Zip: _95670 <br /> 1phune If- ( 916 ) 985-4810 <br /> r <br /> Date lank Received- <br /> ISI nature• Title: <br /> ••11111•••r•f.err•••••♦rr•r•♦•••••r•s•rrr••rrrrr•r•N 11111111.11••11/r•1r11111r11r111f1/1.1f111.f1r1f• <br /> Page Ill <br /> to 23 049 (Rev 2/9/91) WP <br /> ' A Uhittnn or sxn fnxRuln(nuntr health Core iMicts <br />