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,' f l`C) �,AIUD �7%� 1 '��k_Z " Page of Facility Address: City: 2� in t' 1 ate- FA #: R #: Program Element; 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. Tank (2820) ❑ Containers (2821) #of Containers: TA#: �5 pd2 1 Total Capacity: �(� o Pi gallons Product Type: 4L ', +/ (per tank or cumulative for containers by product type) Install Date: ank (2820) ElContainers (2821) #of Containers: TA#:`moi $ D 2 Total Capacity: 6�9- gallons Product Type: _ /p A�% (per tank or cumulative for con ainers by product type) Install Date: ank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Total Capacity: gallons Kk Product Type: � ),,r,,7/' (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: >� ❑ Tank (2820) Containers (2821) .05- 4 r Product Type: Total Capacity: gallons (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: < < 5 gallons Total Capacity for Site: % S —� gallons Comments: EHD Inspector: z Reviewed Date: �1 By Initial: �AA f �l Entered Date: 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