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I� > " <br /> '+w. 1�0:�N(Ei�T�.Lri�AI EPa_RTYIC�I�. <br /> 600 East&T-1L-1Street, Stockton, CA 95202-302 <br /> - aen. c�i�e: (�09)46$-3420 Fax: (209)458-34 3 i?�eb:w1,wv.sjgov.oro#'ehd <br /> k Facility Name: y PacFe J O <br /> City: (inspection nte: <br /> Facility Address: if <br /> r <br /> P� <br /> f U P� ., Program'Element: <br /> FA : <br /> Tank-/Contain <br /> Information <br /> Complete for all sites with cumulative aboveground storage of p6troletim 1320 gallons in tanks and containers over 55 gallons. <br /> F Complete one box-for each tank or each cumulative corttaiu:er product type. € <br /> Tank (2820) ❑ Containers (2821) 4#of Containers: _ T.A4.: <br /> I >55 gallons olid<250 gallons) <br /> (>250 gallons) <br /> 1 Product Type: <br /> Total Capacity: yrf.� . <br /> P �'� b gallons Install-Date: <br />+ (per tank or cumulative for containers byproduct type) <br /> [I Tank (2820) ❑.Containers (2821)-- FOf Containers: TA#: , <br /> r>75n�:li ,� (»5 gators and<250 oaiic,S) f 1 <br /> pTor >,?cr.Type: t <br /> '-otal Capacity: 1 i <br /> 1 b`z r1s install Date: <br /> (per tank or cumulative for containers by product type) <br /> T <br /> nk (2820) D Containers (2821) #o f Containers: TA4: i <br /> j. gallons) (>55 gallons and 2250 gallons) t ! <br /> -, Product Type: � <br /> T otai Capacity: gralions �_19ta: vot_ l <br /> l lz Date: <br /> (k;er+ank or cumulative for containers by product type)_ <br /> Z'S <br /> , + p atpF',7'R TA': <br /> 2 £ <br /> 4201 C L <br /> f i i 750 oft ,j (>55_odor[=ar_d<250 gallons) <br /> ! _1.10iiS 1 m Product - 1ke t <br /> i T% v'a, aui#cr ballo'r�=, r_ 1 iat,-: f <br />} � !•; ` - �° ��,�iiia ��� <br /> -- ' <br /> ,,._ uFK DY.0 iii ii:k»Lig/C_Ci CU:it2i11C5 uy pt'oduct type + { <br /> ,1 1 nCrr1r '2N ) ❑ iJ 11k G'ntrs (2SL 1) ''„fill Containers.-; <br /> 1 € 0c <br /> 250 gallons) (> g�++lions anr'.<250 gallons) <br /> f I _li Jam' 1v 1 IC,: <br /> i Cts? Lapac_i K:'_i'_t z 3 3!_Witte: <br /> t ti1S <br /> A :.-. �:ulati <br /> for <br /> ^ , ine,s by pr.[-act'yrC <br /> - �r::...�.....».=....�...P.....:-. <br /> s <br /> r Revicwed Date: Entered Date: <br /> EHD inspector: I3 Initial: /�� <br />? ` fay[nitiat ,�1, y <br /> f J _ <br />` SPD h-Q I <br /> t;?6110 <br />