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' SAN JOAQUIN COUNTY ; ENVIRONMENTAL HEALTH DEPARTMI I t'� •� ' 600 East Main Street,Stockton,CA 95202-3 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/e'hd h ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: T&I . JAII A,% Ltc Page of n" Facility Address: City: * 1 lnspe ton �a'W III lilt l ; FA#; -PR I Pro rain Element: ( t Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum Z,,1320,gallons in tanks and containers'over 55 gallons. Complete one box for each tank or each cumulative container product type. Tank 2820 ❑ Containers 2821le .( ) ( ) '#of Containers: TA#: �� /C.I?_ � (>250 gallons) (>55 gallons and<250 gallons) - Product Type: t Total Capacity: 1 3o gallons { (per tank or cumulative for containers by product type) Install Date: oq P'l'ank (2820) ❑ Containers (2821) #of Containers: TA#: L 1i e i (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: 7 i It Total Capacity: v gallons (per tank or cumulative for eo tainers by product type) Install Date: (2820) Containers (282 1) #of Containers: ' TA#:ASI& j ____ .__ 50 gallons) (>55 gallons and<250 gallons) 3 Product Type: �f Total Capacity: �d gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) Containers (2821) #of Containers: TA#: 0,5-11e 1 (>250 gallons) (>55 gallons and<250 gallons) 4 Product Type:' Total Capacity: gallons = _ (per tank or cumulative for containers by product type) Install Date: Q Tank(2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons)' (>55 gallons and<150 gallons) 5 Product Type: Total Capacity: t-�70gallons (per tank or cumulative for.containers by product type) Install'Date: Total Capacity this Page: gallons Total Capacity for Site: j gallons Comments: My 144 r_1 r� r EHD Inspector: Reviewed Date: f' Entered Date: By Initial: c��('l-(}b By Initial: EHD 2M I 01/16/08