BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

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: L O GQ�q f Page 2 of [FA acility Address: r1r,O .� City: Insp tion ate: #: R PR#: DO B`3 0528Co/(o ogra Element: Tank/Container Information Z 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, ❑ Tank (2820) M Containers (2821) #of Containers: 2 TA#: BSII� J 1 Product T Total Capacity: �J (� gallons Type: -ld�G{ &7 (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) 5/6ontainers (2821) #of Containers: 2- TA#: 7 L-241- _ 2 Cl) roduct T Total Capacity: � I gallons Type: . (per tank or cumulative for containers by product type) �� Install Date: 1:1 Tank (2820) R Containers (2821) *of Containers: _L TA#: rj 12 71; - 3 Total Capacity: gallons Product Type: (per tank or cumulative for containers by prodwt type) "'- ��,// Install Date: ❑ Tank (2820) �AContainers (2821) #of Containers: TA#: 4 Product Type: ��d Total Capacity: rJOCD gallons cri (per tank or cumulative for containers by product type) Install Date: ❑ 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: 5 gallons Total Capacity for Site: 3/ L-�35 Comments: gallons EHD Inspect Reviewed Date: Entered By Initial: Date: "S-IQ By Initial 'Abovegrnd orage tank means a tank that has the capacity to store 55 gallons or more of petroleum. "Contaihor6eans a storage device designed to be moved when full. EHD 28-01 091 1 2.1 08 AST SURVEY FORM