BILLING - Laserfiche WebLink

Home Browse Search

Nt 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/e'hd ABOVEGROUND PETROLEUM STORAGE- PROGRAM SURVEY FORM Facility Name: Page ofl Facility Address: y rty Inspe do D t FA#: PR#: Progr F 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. 1!3 Tank (2820) ❑ Containers (2821) #at Containers: TA#: 1 �'� Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install bate: ' ank (2820). ❑ Containers (2821) #of Containers: TA#: 2Product Type: Total Capacity: ��`gallons — -• (per tank or cumulative for containers by product type) Install Date: ElTank (2820) ElContainers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: r 1:1 Tank (2820) ElContainers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ElTank (2820) EDContainers (2821) #of Containers: TA#: 5 Total Ca acit Product Type: . p y: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: e�mv gallons Total Capacity for Site: Soo gallons Comments: L ., C O 20 Z 2-017 EHD inspector: Reviewed Date: Entered Date; By Initial: By Initial: i *Aboveground storage tank means a tank that has the capacity to store 55 g flans or more of petroleum. "Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08 ��