BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

N 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: Pageof FacilityAddress: City: Inspectio Date: r r FA j R# Prograrii Element - lemen :530ef 1530 ef 2 Tank/Container Information Complete 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. Tank (2820) ❑ Containers (2821) #of Containers: TA#: L�-Lj 19 1 5 �m Product Type: �A 7 Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 5000 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: J /Containers ❑ Tank (2820) (2821) 3 Total Capacity: 1/ 6gallons Product Type: (per tank or cumulative for containers by product type) Install Date: El Tank Tank (2820) ontainers (2821) #of Containers: TA#: `v 4 Product Type: �I✓•� �� , Total Capacity: 1/0 gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: &,q-1 D� 5 Total Capacity: gallons Product Type: 2E2V Total Capacity this Page: !4 Z Z0 gallons Total Capacity for Site: �4-1-7 0,V gallons Comments: i s -� Z 7 EHD Inspector: C, Reviewed Date: By Initial: h t 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