BILLING_PRE 2019 - 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: N Page__of Z Facility Address: City' Inspection Date: FA FIR#: Program Element:. 1 05-12�s3Z 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. fd'Tank(2820) ❑ Containers (2821) #of Containers: TA#: M �� 1 Product Type: l�111� _Wms 40-,56 Total Capacity: ` gallons (per tank or cumulative for contaldrer7by product type) Install Date: 1 bCaW% �1A In. &1Af Q/ 0v1 Tank(2820) ❑ Containers (2821) #of Containers: TA#: /Qin 24MA2:a o 2 Total Capacity: -zw gallons Product Type: 4PA r t'Tnl/1S 4h�3�6 (per tank or cumulative for containers by product type) tall Date: ❑ Tank(2820) ❑ Containers (2821) +of Containers: A#: 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: 560 gallons Total Capacity for Site: ZSd gallons Comments: EFID Inspector: Reviewed D Entered ate: � By Initial: - �'L Lf l 13 By Initial: I *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. EFID 28-01 09/11/08