BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPART 600 East Main Street,Stockton,CA 9520 29 Telephone.(209)468-3420 Far:(209)468-3433 Web.www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Names, GrvtR Y TE1 6A0/-Lf Page of Facility Address: ' City: c[c�t U lj�✓ InsP D /s r U FA#: PR#: /Z Program leme [: G G /5- 293 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21320 gallons in tanks and containers over 55 gallons. Com lete one box for each tank or each cumulative container product type. ❑ Tank (2820) Containers (2821) #of Containers: 'Y TA#: (>250 gallons) (>55 gallons and<250 gallons) 1 Total Capacity: SC) 41gallons Product Type: ��t (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) Py' ontainers (2821) #of Containers: TA#: N,5-1 117(p3 (>250 gallons) (>55 gallons and Q50 gallons) / 2 Product Type: 441 L/ Total Capacity: 2 0 gallons (per tank or cumulative for containers t fie) Install Date: ❑ Tank(2820) Containers (2821) #of Containers:- ` TAM (>250 gallons) (>55 gallons and<250 gallons) 3 Product Type: p s Total Capacity: L '42-17 gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Containers (282 1) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 4 2 D Product Type: i �� T�AN� Total Capacity: � gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) Containers (2821) #of Containers: Y TA#: (>250 gallons) (>55 gallons and<250 gallons) , 53 2 k�7O � Product Type: j2i L Total Capacity: �Ions (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: Z gallons Comments: EHD Inspector: Reviewed Dale: dd Entered Date: By Initial: �� b.yp-DD By Initial: w v EHD 28-01 !/ 01/16/08