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: Page of Facility Address: C ' ity: Inspec on Da FA#: /�� —PR� Pro ra�Elgm�t : 7 ,5 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. 52 Tank (2820) ❑ Containers (2821) #of Containers: TA#: 418a 1 1 Product Type: ,S Total Capacity: r gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: . T : 06 ) 8'99 2Total Capacity:p y l " gallons Product Type: 11 (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: (fib 1 3 Product Type: � Total Capacity: � gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) E9/Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Containers (2821) #of Containers: . TA#: 5 Total Capacity: �� gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Pacg,. © gallons Total Capacity for Site: gallons Comments: EHD Inspector: Reviewed , ' Date: Entered Date: By Initial: VJ A By Initial: g *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more o petroleum. v **Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08