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SAN JOAQUIN COUNTY <br /> ..ENVIRONMENTAL HEALTH DEPARTMENT+.. <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax.(209)468-3433 Web:www.sjgov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br /> Facility Name: <br /> Acampo Ag Service (Manna Ranch Inc.) Page 2 o 2 <br /> Facility Address: City: Inspection Date: <br /> 775 E. Acampo Rd. Acampo Sep 1, 2011 <br /> FA#: PR#: Program Element: <br /> 9713 ^ 7� �, ; 2832 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum 2_1,320 gallons in tanks*and containers**. <br /> Complete one box for each tank or each cumulative container product type. <br /> FX Tank (2820) -1Containers (2821) #of Containers: TA#: <br /> 1 Total Capacity: 150 gallons Product Type: oil `C A6SI tj473 <br /> (per tank or cumulabve for containers by product type) Install Date: unknown <br /> ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 2Total Capacity: gallons <br /> 150 Product Type: oil TA6S1 WY <br /> (per tank or cumulative for containers by product type) Install Date: unknown <br /> ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 3 Total Capacity: gallons 110 Product Type: used oil TA (X1 2 <br /> (per tank or cumulative for containers by product type) Install Date: unknown <br /> F-1 Tank (2820) 0 Containers (2821) #of Containers: 3 TA#: <br /> 4 Total Capacity: gallons 160 Product Type: oil -tA q S <br /> (per tank or cumulative for containers byproduct type) Install Date: unknown <br /> ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 5 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: 570 gallons Total Capacity for Site: 12,570 gallons <br /> Comments: <br /> While on site to conduct a HW inspection, AST's were observed. <br /> EHD Inspector: Reviewed Date: n Entered Datg / <br /> By Initial: G � By Initial: lU <br /> *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum <br /> *Container means a storage device designed to be moved when full. <br /> EHD 2e-01 REV 06/03/10 AST SURVEY FORD <br />