BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMI 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: /D D S U Page Z_ of Facility Address: City: Inspect'on D te: 0o cLvFP A� o o /I // 0 FA#: PR#: Program Element: 000 9995-, 1 51, 5-99 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >_1320 gallons in tanks and containers over 55 gallons. L Complete one box for each tank or each cumulative container product type. "T 15 ank (2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: Total Capacity: /G O o D gallons (per tank or cumulative for containers by product type) Install Date: El-Tank (2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: Total Capacity: /0 G0 0 gallons " (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: . TAM ClJ,A;7/�17t9( (>250 gallons) (>55 gallons and<250 gallons) n / 3 Product Type: Total Capacity: /D G t1 O gallons (per tank or cumulative for containers by product type) Install Date: E�Tank (2820) ❑ Containers (2821) #of Containers: TAM t9 /!Zf�2,R, (>250 gallons) (>55 gallons and<250 gallons) n' 4 Product Type: ,(J Total Capacity: /D e�'d U gallons (per tank or cumulative for containers by product type) Install Date: 04-fank (2820) ❑ Containers (2821) #of Containers: T #: (>250 gallons) (>55 gallons and<250 gallons) 5 Product Type: Total Capacity: /D COV gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: S C:> C? C d gallons Total Capacity for Site: a Z(7U gallons Comments: EHD Inspector: Reviewed Date: I I i) Entered Date: C - 6 By Initial: v1d By Initial: EHD 28-01 01/16/08