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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/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: San Joaquin Delta College Page 1 of 2 Facility Address: City: Inspection Date: 5151 Pacific Ave Stockton Jan 11, 2011 FA #: PR #: Program Element: FA0002836 PRO516609 2831 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. #of Containers: TA#: 0516962 Tank (2820) ❑ Containers (2821) 1 Product Type: diesel 1 000 Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: 0516963 Tank (2820) ❑Containers (2821) 21 000 Product Type. 87 octane gasoline Total Capacity: � gallons (per tank or cumulative for containers by product type) Install Date: Q Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 500 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: TAM 06-9,20 *ZeZ 4 Product Type: diesel 500 ons Total Capacity: gall (per tank or cumulative for containers by product type) Install Date: XJ Tank (2820) ❑ Containers (2821) #of Containers: TA#: A URP©73 5 500 Product Type: diesel Total Capacity: gall ons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 3,500 gallons Total Capacity for Site: 4,050 gallons Comments: 1,2: used to fuel vehicles 3,4,5: diesel generator tanks EH ctor: ,*' 7By Reviewed Date: Initial: J 1 �1 r� Entered Date: By Initial: *�Cboveground storage tank means a tank that has the capacity to stare 55 gallons or more of petroleum. *Container means a storage device designed to be moved when full. EHD 28-01 REV 06/03/10 AST SURVEY FORM