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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br /> Facility Name: <br /> Goehring Pump & Irrigation Page 2 of <br /> Facility Address: City: Inspection Date: <br /> 17754 N. Hwy 88 Lockeford CA 95237 Lockeford Sep 27, 2010 <br /> FA#: PR#: Program Element: <br /> FA0009941 0 53 5 L �3 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum_>1,320 gallons in tanks*and containers**. <br /> Complete one box for each tank or each cumulative container product type. <br /> E] Tank (2820) - -ConTaiff Ts4)---stainers: 1 TA#: L�519 3 g <br /> 1 55 Product Type: er <br /> Total Capacity: gallons Q <br /> (per tank or cumulative for containers by product type) Install Date: r o— <br /> [I Tank (2820) X❑ Containers (2821) #of Containers: TA#: D S(R 3n7 <br /> 2 ,I� Product Type: oil <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank(2820) ❑ Containers(2821) #of Containers: TA#: <br /> 3 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) <br /> Install Date: <br /> ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 4 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 5 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: gallonsTotal Capacity for Site: 2,600 gallons <br /> Comments: ,. <br /> Girl 1,1\j <br /> � �V✓ <br /> EHD Inspector. Reviewed Date: Entered , Date: <br /> By Initial: By Initial- �� /3�((Q <br /> *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. <br /> **Container means a storage device designed to be moved when full. <br /> EHD 28-01 REV 06/03/10 AST SURVEY FORM <br />