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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Zoom Car Wash Page 1 of 3 Facility Address: City: Inspection Date: 4661 Quail Lakes Drive Stockton Nov 13, 2013 FA #: PR #: Program Element: 18642 0,38 1 & oZ 2831 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks' and containers". Complete one box for each tank or each cumulative container product type. X Tank (2820) ❑Containers (2821) #of Containers: TA#: 0517521 1 Product Type: motor oil Total Capacity: 220 gallons (per tank or cumulative for containers by product type) Install Date: FX Tank(2820) ❑ Containers (2821) #of Containers: TA#. 0517522 j 2 220 Product Type: motor oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: X❑ Tank (2820) F1Containers (2821) #of Containers: TA#: 0517523 f 3Product 1,000 Type: motor oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: FX]Tank (2820) F]Containers (2821) #of Containers: TA#: 0517524 / 4 2,000 Product Type: motor oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: 0517525 5 Product Type: ATF 250 Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 3,690 gallons Total Capacity for Site: 7,380 gallons Comments: EHD In or: Reviewed Date: By Initial:R (� `? Entered Date: By Initial:zz /I 00 (� a o egr and storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. / "Container means a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM