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: r-1--r-1-- .�' �c. a Page of ' Facility Address: City: 15$A7 Inspect'o �tq: rI ' FA#: /� PR M 0 Progr m �a 2 7b Tank/Container Information Comple 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. Eh/Tank (2820) ❑ Containers (2821) #of Containers: TA#: V 1 Total Capacity: -i7 apacity: / 00 (7 gallons Product Type: J�Q ) (per tank or cumulative or containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#; $ LZT 2 Product Type: - Total Capacity: TrCrdlo gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ 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 Page: 0 00 gallons Total Capacity for Site: Q gallons Comments: EHD Inspector: Reviewed Date: Entered Date: By Initial: ll 1`� p 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