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ENV i ROTNNIl~..N A?14F_A v 1 H DEPARTy_f.E T� <br /> 600 East i`Ilain Street, Stockton, CA 95202-3029 <br /> Telenhorae: (209)468-3420.F'ax (209) 468-3433, Webo yvww-sjgov.orc�ehd <br /> VEGROUND PEE OLE UM S <br /> I' Facility ame: 0,q G S ��CI /� 0pfl, Page I O <br /> 20 el 7-y <br /> C Inspe�ionroate <br /> Facility Address: <br /> 9 � p �G r <br /> �PR#" Program EFA g <br /> jq � 8'D <br /> Tank/Containe,r Information <br /> Complete for all sites with cumulative aboveground storage of petroleum ?1320 gallons.in tanks and containers over 55 gallons. <br /> Complete one box for each tank or each cumjulative container product type. l <br /> Tax]k (2820) 0 Containers (2821) sof Contailaers <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 1 Product Type:' , <br /> Total Capacity: S gallons Install Date: <br /> (per tank or cumulative.for eontaine_rs by product type) <br /> El T ,�k (2820) Containers (2521) t of Containers: A, <br /> � El _ 1� <br /> (725+)gal i,=.) (>55_,.,aIl4rc and<250 gallon) � I <br /> 2 Pr6duct Type <br /> 3 <br /> 1 ' Tota! C'2"'acity ' 'alloy 1 <br /> I (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank (2820} ❑ Containers (2821) 7-of Containers: T : <br /> (7250 gallons) (>55 gallons and<250 gallons) <br /> -, Product Type: <br /> 0 1 iai Capacity: gallons <br /> ` lits?Cri . .L1�1La.. Y <br /> (rer",�tk ar cumulative for containe,s h3,'product t,�e} i <br /> 3 <br /> 1Q � , r;rc. (282 1 it r r � , P�. <br /> y t ❑ ~l�_ti 1 4 ! i ❑ �t?nd_r! `�_1� tion ci z!rr5' Tyr_ i <br /> / S (>250 gallons) (%55 gallons and<250 gall.^,ns) J 1 <br /> �1 1 tOLI.�L'L I Y'�i' 9 <br /> T Q a'I cainacitu: gallnris. I• <br /> _��t:2ir:a fbr contalie:s by p.:;;ducl c='ue'; ; <br /> g I <br /> Tan]-, (222v� i° TI rr: — 3 <br /> 0 C'iiLa.—neTs { 202.1 j hof C.(] ta1llf'LS: <br /> o ! (>`5 gallons Lnd<250 cal{ans) <br />` I� (>L50 gallons) <br /> J� 1 <br /> 3 .. To1C'l InSt. <br /> �//i/0._...�._...i�--�._ `3.:;�LtiT3•`�i <br /> ..'/..,F;__.�. - �--.............. ,.,.�..e..—a <br /> t <br /> V <br /> Y <br /> EF1D{nspcctor: ltavlewed- Date: Entered Date: +fir <br /> f ✓" ��' 6y Initial: 1A- By 1niCAaE_ <br /> Eli 2S-01 <br /> 011`!6103 <br />