BILLING - Laserfiche WebLink

Home Browse Search

• SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 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: li G 1L U LIZ-//✓ �- S%�� L i n!� Page of Facility Address: 0 5- 2 City: In specV n Da : d� - L 2-a 0 FA #: 19 4- / 2 PR #: Program E e en . 1 -2,930 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks* and containers**. Complete one box for each tank or each cumulative container product type. D--fank (2820) 11Containers (2821) #of Containers: TA#: D 61 l 1 Total Capacity: / U O O gallons Product Type: Jr-: (per tank or cumulative for containers by product type) Install Date: 9"f ank (2820) ❑ Containers (2821) #of Containers: TA#: d 2 Total Capacity: /-6 - gallons Product Type: /r/ .S (per tank or cumulative for containers by product type) Install Date: L Tank (2820) ❑ Containers (2821) #of Containers: TA#: U6 1(313.3 3 .� r 0 Total Capacity: agallons Product Type: •� � (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: Z Tank (2820) ❑ Containers (2821) 4 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: � 000 gallons Total Capacity for Site: n C gallons Comments: EHD Inspector: �j Reviewed Date: By Initial: 1�-ftp Q� Entered Date: By Initial: 6 f D *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. **Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08