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: h Page_ of L_ Facility Address: �� City i Inspection Date: ,Ude '/- 2, S ` O FA M PR M Program Element: Lo Z� 3 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. Tank (2820) ❑ Containers (2821) #of Containers: TA#: S'6-1 q 1 -7 S 0 gallons Product Type: Total Capacity: (per tank or cumulative for containers by product type) Install Date: EI/Tank (2820) ❑ Containers (2821) #of Containers: A#: aO 2Product Type: Total Capacity: 7--0-0-0gallons (per tank or cumulative for containers by product type) Install Date: ank (2820) ❑ Containers (2821) #of Containers: TA#: 4L-T l Ssa 3 Product Type: Total Capacity: gallons (per tank or cumulative for cont' iners by product type) Install Date: P Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Total Capacity: gallons Pr uct Type: (per tank or cumulative for conta rs product type) Install Date: ter,72: 9Yfank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Total Capacity: gallons Product Type: L12±0 (per tank or cumulative for containers by product type) Install Date: /n 7;� Total Capacity this Page: j gallons Total Capacity for Site: gallons Comments: EHD Inspector: ! -Tviewed Date: Entered Date: Initial: By Initial: "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