BILLING - Laserfiche WebLink

Home Browse Search

�. t.. x. SAN JOA6U)N 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: /VE Page I of Facility Address: o City: Inspection ?06 All T(5,6,6A FA#: / �� PR#: Program Element: s Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum Z,1,320 gallons in tanks*and containers**. \ Complete one box for each tank or each cumulative container product type. I #of Containers: TA#: Tank (2820) ❑ Containers (2821) � Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ` #of,Containers: TA#: ' Tank (2820) ❑ Containers (2821) 2 x Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) install Date: i El Tank (2820) El Containers (282.1) #of Containers: TA#: r 4 3 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ElTank (2820) ElContainers (2821) #of Containers: 'TA#: r 4 Total Capacity: gallons Product Type: P Y i. (per tank or cumulative for containers by product type) Install Date: n, ❑ 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: ov gallons. Total Capacity for Site: gallons Comments: EHD Inspector: �, Reviewed „ �Q� Date: Entered Date: By Initial: WN ��” 1 By Initial: *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. 4 "Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM q9/12108