BILLING - Laserfiche WebLink

Home Browse Search

s , 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 STORA E PROGRAM SURVEY FORM Facility Na e: - 1. - j S Gg�. NCJ Page of . 1 i Facility Address: City: Inspection Date: }} FA#: PP M Program Element: Tank/Container Information Complet for all sites with cumulative aboveground storage"of petroleum 2-1,320 gallons in tanks*and containers"". Complete one box for each tank or each cumulative container product type. ZTank (2820) ❑ Containers (2821) #of Containers: TA#: 1 Total Capacity: gallons Product Type: 7.c��U ... (per tank or cumulative for co tamers by product type) Install;Date: T� Gl/A O �✓ EV/Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Total Capacity: gallons Product Typ?: . (per tank or cumulative for containers by product type) I nStall'.Date: LA 4�6 6Z ❑ 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) Containers (2821) #of Containers: TA#: 4 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) - Install Date: ElTank (2820) ElContainer's (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons — (per tank or cumulative for containers by product type) Instal l,Date: Total Capacity this Page: gallons Total Capacity for Site: O gallons Comments: GZ,, TAA7A_3_0oq EHD Inspector: Reviewed Date: Entered Date: G. By Initial: Q� (�',1 By Initial �f zj *Aboveground 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 AST SURVEY FORM 09112/08