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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 hof 1 <br />Facility Address: <br />City: <br />Inspection Date: <br />2121 N Zuckerman Road <br />Stockton <br />Jul 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 <br />tanks* and containers". <br />Complete one box for each tank <br />or each cumulative container product type. <br />❑X Tank (2820) ❑ Containers (2821) <br />#of Containers: TA#: <br />1 <br />Product Type: Production Fluids <br />520 ons <br />Total Capacity: gall <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />X❑ Tank (2820) ❑ Containers (2821) <br />#of Containers: TA#: 12 <br />,WlkO <br />2520 <br />Product Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />❑X Tank (2820) F-1Containers(2821) <br />#of Containers: TA#: <br />•2� <br />3Product <br />1,080 <br />Type: Production Fluids <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />❑ Containers 2821 <br />❑X Tank (2820) ( ) <br />#of Containers: TA#: <br />8�Q201" PS <br />4 <br />11,000 <br />Product Type: Platform runoff <br />Total Capacity: gall ons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />❑X Tank (2820) ❑ Containers (2821) <br />#of Containers: TA#: <br />z D(P <br />511,000 <br />Product Type: Platform runoff <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />Total Capacity this Page: 24,120 <br />gallons Total Capacity for Site: <br />gallons <br />Comments: <br />EHDIn tor: <br />/J <br />Reviewed Date: /; ` 1 <br />By Initial: <br />Entered <br />By Initial: <br />Date: <br />1 <br />/ <br />�--Container <br />ove*und storagetank means a tank that has the capacity to store 55 gallons or more of petroleum.' <br />means a storage device designed to be moved when full. <br />EHD 28-01 REV 04/19/12 AST SURVEY FORM <br />