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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 East Main Street, Stockton, CA 95202-3029 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: Chrisp Company Page 1 of 1 Facility Address: City: Inspection Date: 1001 Stokes Ave. Stockton Jan 26, 2011 FA #: PR #: Program Element: FA0018140 P5 4, DJ L 2831 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21,320 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#: D5o7D�9$$ 1 Product Type: diesel Total Capacity: 1, gallons 000 (per tank or cumulative for containers by product type) Install Date: unknown X❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: �� o2DD8� 2Product Type: used oil Total Capacity: 250 gallons (per tank or cumulative for containers by product type) Install Date: unknown ❑ Tank (2820) X❑ Containers (2821) #of Containers: TA#: PZ a D©4'o 3 Product Type: used oil Total Capacity: 55 gall ons (per tank or cumulative for containers by product type) Install Date: unknown ❑ Tank (2820) X❑ Containers (2821) #of Containers: 2 TA#: i95,tVP 4 110 Product Type: hydraulic oil Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: unknown ❑ 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: 1,415 gallons Total Capacity for Site: 1,415 gallons Comments: EHDsector: t I Reviewed By Initial: Date: l J I 2� 4 Entered Date: By Initial: boy g storage tank meahn tank that has the capacity to store 55 gallons or more of petroleum. ` .Co means a storage device designed to be moved when full. EH D 28-01 RE 06103110 AST SURVEY FORM