BILLING PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY S ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: LG Page 7 of Facility Address: Cit : InspecJlon D te: FAN: a: Program Element: �S j 7 Tank/Container Information c� Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks*and containers**. Complete one box for each tank or each cumulative container product type. ❑ Tank (2820) [ Containers (2821) #of Containers:_L TA#: zP6A- r/,/D q 1 Total Capacity: gallons Product Type: VIS4a D cX (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Containers (2821) #of Containers: �_ TA#: AS21)le t70 2 Total Capacity: e g gallons Product Type: .lw-C L (per tank or cumulative for containers by product type) ! Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TAM 3 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: O gallons Total Capacity for Site: -7 gallons Comments: EHD nspector: Reviewed Date: Entered Date: By initial: QuVt .rS�i BY Initial: *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. **Container means a storage device designed to be moved when full. EHD 28-01 AqT CI IR\/Fv PnPRA