BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY - ENVIRONMENTAL HEALTH DEPARTMENT a ENT .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: Page-._- of 1 Facility Address: city: Inspection Date: _lc_ l g v FA C E1562U/ II Prog am EI Ment: o D S' D Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks*and containers"'*. p Comlete one box for each tank or each cumulative container product.type. Tank (2820) ❑ Containers (2821) #of Containers:. TA#: 1 Product Type: S W -3v .L.4..r Total Capacity: . . gallons (per tank or cumulative for containers by product type) Install Date: #of Containers:: TAM i LS,,,Tank (2820) ❑ Containers (2821) 2 Product Type: S 3a f,._.4.".-.�,` Total Capacity: 1.2-0 gallons.(per tank or cumulative for containers byproduct type) Install Date:' i i Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product.Type. Total Capacity: 440o gallons I (per tank or cumulative for containers by product type) Install Date: i Tank (2820) F-1Containers" (2821) #of Containers: TA#: iProduct Type: I 4 Total Capacity: 2�0o gallons �. I (per tank or cumuiauve for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#:_ 5 Product Type: Total Capacity: /Zo_ gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 6 gallons. Total Capacity for Site: �� gallons Comments: 7f F EFED In cta Reviewed Date: Entered Date: By Initial By Initial:CAfp6 Veground s orage tan means a tank that has the capacity to store 55 gallons or more of petroleum. * ontainer means a storage device designed to'be moved when full. EHD 28-01 09/12/08 - AST SURVEY FORM 6