BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ,NVIRONMENTAL HEALTH DEPARTMEN`. --ro0 East Main Street,Stockton,CA 95202-302 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Page --/ _of Q Gd p Clty: Inspecu Dal Facility Address: e: .4 o s� FA#: PR#: Program Element: b B 6L 2 $ 3/ Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21320 gallons in tanks and containers over 55 gallons. Complete one box for each tank or each cumulative container product type. ank(2820) ❑ Containers (2821) #of Containers: TAM 4 (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: Total Capacity: Z d 0 gallons Install Date: (per tank or cumulative for containers by product type) r4/Tank(2820) ❑ Containers (2821) #of Containers: TAM (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: /110'rO IT- 0/ Total Capacity: 3 .70 gallons (per/tank or cumulative for containers by product type) Install Date: O Tank (2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) .✓r>55,gallons and<250 gallons) 3 � Product Type: wi d%D/l- O< Total Capacity: 2 ZS gallons Install Date: (per tank or cumulative for containers by product type) �ank(2820) ❑ Containers (2821) #of Containers: TA#: B,�5-/3c1-1--CC22- 4 (>250 gallons) (>55 gallons 7d<250 gallons) Product Type: Total Capacity: �0 0 gallons (per tank or cumulative for containers by oduct type) Install Date: El Tank(2820) M Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 5 Product Type: 11S'O/LyJC,IC. B� Total Capacity: ZSo gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page-./7S 5 gallons Total Capacitv for Site: ��`7 gallons Comments: EHD Inspector: C /� Reviewed Date: Entered Dale: O> By Initial: 7.'11,O By Initial: EHD 28-01 01/16/08