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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 3of 3 Facility Address: City: Inspection Date: 4661 Quail Lakes Drive Stockton Nov 13, 2013 FA M 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. 2820 X❑ Tank) ( ❑Containers (2821) #of Containers: TA#: 0517531 1 1,000 ,l Product Typ( Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Product Type: 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 Tank(282o) ❑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: 1,000 gallons Total Capacity for Site: 7,380 gallons Comments: /,\\/ EHDctor: �) Reviewed Date: By Initial:QjV� l i1,3 Entered Date: By Initial: �(4 2 l z boveground 9torage 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