Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> 3 ;�•• OENYIRONMENTALHEALTH DEPARTMENT` <br /> 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax.(209)468-3433 Web:www.sjgov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br /> Facility Name: --7 <br /> Page ( of� <br /> !✓ <br /> Facility Address: City: Inspect. n <br /> EE <br /> FA#: PR#: Program menta <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum Z 1320 gallons in tanks and containers over 55 gallons. <br /> Complete one box for each tank or each cumulative container product type. <br /> XTank(2820) ❑ Containers (2821) #of Containers: TAM VA5I6 Rroo-�R- <br /> (1250 gallons) (>55 gallons and Q50 gallons) <br /> 1 Product Type: U( 1 --i, <br /> Total Capacity: U gallons Install Date: <br /> (per tank or cumulative for combiners by product type) <br /> Y Tank(2820) El Containers (2821) #of Containers: TA#: <br /> ( 250 gallons) (>55 gallons and Q50 gallons) <br /> 2 /��-t n^` <br /> Product Type: c% [ 4:9 , ro"u( )--q \ <br /> Total Capacity: ()IJ U gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> k-Tank(2820) ❑ Containers (2821) #of Containers: TA#:tQ��,S9(a <br /> (>250 gallons) (>55 gallons and Q50 gallons) p b <br /> 3 Product Type: OI �Prn A'\ <br /> Total Capacity: UD gallons Instal] Date: <br /> (per tank or cumulative for c t—m by product type) <br /> IK Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> (1250 gallons) (>55 gallons and Q50 gallons) <br /> 4 Product Type: '6U In� 6L ��c <br /> Total Capacity: 00 v gallons <br /> (per tank or cumulative for confainers by product type) Install Date: <br /> Tank(2820) ❑ Containers (282 1) #of Containers: TA#: <br /> (>250 gallons) (>55 gallons and Q50 gallons) <br /> 5 Product Type: Q b ED �l e S t-C <br /> Total Capacity: 00D gallons Install Date: <br /> (per tank or cumulative for containers byproduct type) <br /> Total Capacity this Page: D d(3 b gallons Total Capacity for Site: l b V gallons <br /> Comments: <br /> EHD Inspector: Reviewed t^ Date: Entered Dat : <br /> By Initial: l JA By Initial: <br /> 1 114 <br /> EHD 28-01 <br /> 01/16/08 <br />