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r NSAN 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 STORAGE PROGRAM SURVEY FORM Facility Name: General Mills Page 2 o 2 Facility Address: City: Inspection Date: 2000 W. Turner Rd. Lodi, CA 95242 Lodi Jun 29, 2011 FA#; PR#: _ Program Element: 3881 Of 3(Q ( ?d 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#: 1 Total Capacity: 200 gallons Product Type: used oil (per tank or cumulative for containers by product type) Install Date: unknown ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Product Type: Total Capacity: gallons (per tank or cumulative for wntainers by product tyre) 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) ❑ 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: 200 gallons Total Capacity for Site: 2,345 gallons Comments: EHD Ins ect ,t/ Reviewed Date: Entered Date: p By Initial: nU �I By init"I *Aboveground storage tank means a tank that has the capacity to st re 55 gallons or more of petroleum. "*Container means a storage device designed to be moved when full. EHD 28-01 REV 06103/10 AST SURVEY FORM