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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 2 of 2 Facility Address: City: Inspection Date: 5151 Pacific Ave Stockton Jan 11, 2011 FA #: PR #: Program Element: FA0002836 PR0516609 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: 5 TA#: �Q �� D73 ❑Tank (2820) ❑X Containers (2821) 1 275 Product Type: motor oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑X Containers (2821) #of Containers: 5 2275 Product Type: used oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 550 gallons Total Capacity for Site: 4,050 gallons Comments: EHD Inspector: i �, ' Revieweda Date: By Initial: n L V 1' ` S1\ 1` Entered ,n Date: By Initial: /✓j/ / a 1 `Ab)ieground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum, ** ontainer means a storage device designed to be moved when full. EHD 28-01 REV 06/03/10 AST SURVEY FORM