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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br />Facility Name: <br />PG&E McDonald Island <br />Page 4 of V7 <br />Facility Address: <br />City: <br />Inspect' n Date: <br />2121 N Zuckerman Road <br />Stockton <br />Tul 15, 2013 <br />FA #: <br />PR #: <br />Program Element: <br />7096 <br />530292 <br />2833 <br />Tank/Container Information <br />Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks" and containers'". <br />Complete one box for each tank or each cumulative container product type. <br />#of Containers: TA#: ® tS2l,.�IA <br />❑X Tank (2820) ❑ Containers (2821) <br />1 <br />Product Type: Production Fluids <br />12000 <br />, <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />#of Containers: TA#:�- <br />❑X Tank (2820) ❑ Containers (2821) <br />212,000 <br />Product Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />#of Containers: TA#: <br />x1 Tank (2820) F-1Containers (2821) <br />3 <br />500 Product Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: JT <br />4 <br />1,000 Product Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />Tank (2820) F-1Containers (2821) #of Containers: TA#: ILL <br />5470 <br />Product Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />Total Capacity this Page: 25,970 gallons <br />Total Capacity for Site: gallons <br />Comments: <br />EHD In ctor: <br />ReviewedDate: q <br />By Initial: �� �% J� 13 <br />Entered Date: <br />By Initial: g <br />3 <br />l <br />toveground storage'tank means a tank that has the capacity to store 55 gallons or more of petroleum. <br />*Container means a storage device designed to be moved when full. <br />EHD 28-01 REV 04/19/12 AST SURVEY FORM <br />