BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTME 600 East Main Street,Stockton,CA 95202-3029 Telephone:(209)468-3420 Far:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: 9+,-ay- BNilPage r of Facility Address: City: Inspection Date: i2-101 F= . Lx�l) FA#: V7PR Program Element: lt'4o1 9- Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21320 gallons in tanks and containers over 55 gallons. Complete one box for each tank or each cumulative container product type. l /CP Tank(2820) El Containers (2821) #of Containers: �- T �1 - (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: mel 7C iA40 Total Capacity:m *1<S gallons -Install Date: (per tank or cumulative for containers by product type) ❑ Tank(2820) Containers (2821) #of Containers: '2 TA#: 06-1 (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: p'ti� of 1 Total Capacity: 5� gallons (per tank or cumulative for containers by product type) Install Date' ❑ Tank(2820) LTJ Containers (2821) #of Containers: 3 TA#: (>250 gallons) (>55 gallons and<50 gallons) t 3 Product Type: r l L Total Capacity: S5gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) LTContainers (2821) #of Containers: I TA#: (>250 gallons) (>55 gallons and<250 gallons) 4 Product Type: �yt7ns5w+;�'Sl o„I Total Capacity: ss- gallons (per tank or cumulative for containers by product type) Install Date: _ ❑ Tank(2820) 1 Containers (2821) #of Containers: Z TA#: (>250 gallons) (>55 gallons and<250 gallons) �–. L 5 Product Type: �- .�--�� L iLt�jrililN7 Total Capacity: SS gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: i (} gallons Total Capacity for Site: tgU gallons Comments: Prt CC— oa k V"A Ow zkil EHD inspector, Reviewed ate: d Entered Date: By Initial: 3 C O bit By Initial: tt— EHD28-01 ll V 01/16/08