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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: Stockton East Water District Page 2 of 3 Facility Address: City: Inspection Date: 6767 E. Main Stockton 4/3/2013 FA #: PR M Program Element: 0004024 537644 2832 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#: o2��4 Q Tank (2820) F-1 Containers (2821) 1 Product Type: diesel 100 Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ) / #of Containers: TA#: `,c o2Ph ce ZTank (2820) F1/5 Containers (2821) 2Total Product Type: diesel 100 ons Capacity: gall (per tank or cumulative for containers by product type) Install Date: ) #of Containers: TA#: ❑X Tank (2820) ❑ Containers (2821) 3 200 Product Type: diesel Total Capacity: gall ons (per tank or cumulative for containers by product type) Install Date: ) X❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: �91_15-ap 4 660 Product Type: diesel Total Capacity: gall ons (per tank or cumulative for containers by product type) Install Date: ) ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 200 Product Type: diesel Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ) Total Capacity this Page: 1,260 gallons Total Capacity for Site: 18,910gallons Comments: EHD Inspec Reviewed Date: Entered Date: By Initial:\\ By Initial: �✓ A e n forage tank=e-,ins a tank that has the capacity to store 55 gallons or more of petroleum. ""Contai er eans a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM