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• i i <br />ex S71RX Crr <br />L)NDERGROWD TANK DISPOSITION TR=ING RECORD <br />SOCTION I'- The San Joaquin Local Health bistrict's Tracking Sheet will accompany each tank <br />affixed with its site identification er. The Tracklng�Sheet isto •::-:returned to San <br />Jroaquin LocalDistrict within 30 days of acceptof by disposal or <br />"UZIng that thig• m in completo -.Wjgt=WdA— <br />foZZLITY NAME: JIM <br />THORPEr <br />FAMITY ADDRESS: 351 N. Beckman Road, Lodi , CA 95240 <br />TAW ID 139- r <br />• removal contr• <br />Remomi Contractor: JIM THORPE OIL, INC. <br />Address: 351 N. Beckman Road, Lodi, CA Zip: 95240 <br />F #: (209)462-4581 <br />Tele : t ) Date Tank Removed: <br />ION 3 -To be filled out by contractor "decontaminating tank": <br />Decontamination" actors JIM THORPE OIL, INC./ Nor -Cal Hauler of Rinsate <br />as s: 807 E. Black Diamond, Lodi, CA Zip: 95240 <br />Phone #: 2) 4�2 -4 58 2 <br />belowAuthorized representative of contractor certifies by signing <br />fecontaminated In an approved manner at way be regulated by Department of HealtServices. <br />r <br />WTTTTT =77,1777777,1777 <br />5 , be filled out and signed by . ._ . represnetative of ■m - <br />2 , or disposal facility accepting tank. <br />MWIlity Name <br />SCHNITZER STEEL PRODUCTS CO. <br />12000 FOLSSOM BLVD. Z <br />PI6H® 9 1p: <br />j - Phone# : <br />Date Received: <br />A SIGNAUM M <br />TLE <br />TI <br />RK 23 049 12/88 <br />WILING UCTIONS: FOLD IN HALF AND STAPLE. AFFIX PROPER POSTAM. <br />SAN JOAOUIN LOCAL HEALTH DISTRICT <br />ATTN: UNMGROUND TAW PROGRAN <br />P. 0. BOX 2009 <br />STOCKTON, CA 95202 <br />