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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 2 of 3 Facility Address: City: Inspection Date: 4661 Quail Lakes Drive Stockton Nov 13, 2013 FA #: PR #: Program Element: 18642 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) F-1 Containers (2821) #of Containers: TA#: 0517526 ✓ 1 250 Product Type: gear oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: X❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 0517527 2 220 Product Type: motor oil Total Capacity: gall ons (per tank or cumulative for containers by product type) Install Date: X❑ Tank (2820) ❑Containers (2821) #of Containers: TA#: 0517528 i 3 220 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#: 0517529 , f 4 11000 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#: 0517530 5Product 1,000 Type: motor oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 2,690 gallons Total Capacity for Site: 7,380 gallons Comments: " o �.4 4Z7�,-- (AS 1 P r� O)r.4\ EHMInspe IL- Reviewed Date:Entered IBy Initial: �� (� 13 Date: By Initial: ISI lr 3 G* o'vegrounc 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