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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 /> Quality Tune Up #9 Page 1 of 2 <br /> Facility Address: City: Inspection Date: <br /> 1014 N. EI Dorado Stockton Jun 3, 2011 <br /> FA#: PR#: Program Element: <br /> 10266 2831 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks*and containers**. <br /> Complete one box for each tank or each cumulative container product type. <br /> -1 Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> 1 Total Capacity: gallons 480 Product Type: used oil <br /> (per tank or cumulative for containers by product type) <br /> Install Date: <br /> X❑ Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> 2 Total Capacity: gallons Product Type: motor oil <br /> ons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Q Tank (2820 ontainers (2821) #of Containers: a <br /> 3 Capacity: 80 gallons Product Type: motor oil V4 <br /> (per tank or cu containers by product type) a Date: <br /> ❑X Tank (28 Containers (2821) #of C hers: TA#: <br /> 4 T-dal Ca aci 80 ons Product Type: motor oil FSU <br /> P tY <br /> (per tank or cumulative for container product type) Install Date* <br /> X❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 5 „r, Product Type: motor oil <br /> Total Capacity. �” i gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: 1,,a-2 gallons Total Capacity for Site: +,en gallons <br /> Comments: <br /> The three 80 gallon motor oil tanks are not currently being used. , 1 <br /> W <br /> 3/10 to 01� <br /> LEHD I Review ed /7 y Date:� q ,■ Entered Date: / <br /> I B Initial: f,I�V;✓� U, B Initial: (7//X 0 <br /> *Above ound storage tank means a tank that has the capacity to store 55 gallons or more cif 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 />