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: 7" J Page of — Facility Address: City: Inspection Date: FA #: PR M Prog am ement: �e -2- -z Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum ?1,320 gallons in tanks* and containers**. Complete one box for each tank or each cumulative container product type. ED Tank (2820) ❑Containers (2821) #of Containers: TA#: 1 , Total Capacity: % c / 1--',2 gallons Product Type: �.��i (per tank or cumulative for containers by product type) Install Date: Q'. Tank (2820) ElContainers (2821) #of Containers: TA#: 2 Total Capacity: Z_ gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#:pp 3 ,, Product Type: ? ,. , Total Capacity: �� . ) .,7 gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Cg'Containers (2821) #of Containers: TA#: _Af l &3 02 4 7 r ') Total Capacity: .` �_ gallons Product Type: fC3 21 U /'Z. (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) n/Containers (2821) #of Containers:_ TA#: D�(g �D 5 Total Capacity: , 1- ) gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: �j / J 700 gallons Total Capacity for Site: 0J gallons Comments: EHD Inspector: �� ! ✓ Reviewed By Initial: Date:Entered Date: By Initial: lit ,Abuvegrouno 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