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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Change Oil Now! Page 2 of 2 Facility Address: City: Inspection Date: 720 E Hammer Lane G2 Stockton Jun 27, 2013 FA #: PR M Program Element: 9861 D q 2831 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks* and containers". Complete one box for each tank or each cumulative container product type. #of Containers: TA#: 0517512 ❑X Tank (2820) F-1 Containers (2821) 1 Product Type: 80W90 gear oil Total Capacity: gallons 220 (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑X Containers (2821) #of Containers: 3 TA#: 0517510 2Total Product Type: motor oil 165 ons Capacity: gall (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 385 gallons Total Capacity for Site: 2,975 gallons Comments: EHD Ins ctor: Reviewed Date: By Initial: -7 5 I � Entered Date: By Initial: '7 �� bov round storage ank means a tank that has the capacity to store 55 gallons or more of petroleum. Co tainer means a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM