BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY 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: 0 A Page of Facility Address: & city: Inspectlo Dat S ii /6 0 FA#: PR#: Program Element: Tank/Container Information 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: ((�� TAX (� 1 Product Type: //�iui2,� Total Capacity: gallons (per tank or cumulative for con mere by product type) Install Date: FM.4 ank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Total Capacity: S"Q4b gallons Product Type: (per tank or cumulative for containers by product type) Install Date: EA nTY I I ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 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: / &VV I gallons Total Capacity for Site: gallons Comments: -SC JY1;5AN6 III 5l' 43r 0 44Z 3r FEHD spector Reviewed Date: rpy., Entered Date: By Initial: By Initial: 'Aboveground storage tank means a tank that has the capacity to store 55 gallons or more ol petroleum. "Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08