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: Page of � Facility dress: City: Inspect' n Dpxe A Al FA #: 1019 PR M 1 o a Program Element: -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. -4 Tank (2820) ❑ Containers (2821) #of Containers: TA#: 06-1 '3 1Product Total Capacity: 100 0 gallons Type: (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: 6 .1 (3 L91 1 2 Total Capacity:? gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5-1 g� f oZ 3Product Total Capacity: 2 190 gallons Type: (per tank or cumulative for containers by product type) Install Date: M Tank (2820) El Containers (2821) #of Containers: TA#:_d�'I g� 1 3 4 Total Capacity: .SCS gallons Product Type: ao4z (per tank or cumulative for containers by product type) Install Date: Q' Tank (2820) El Containers (2821) #of Containers: TA#: D5 1 S'O /� 5 Total Capacity: gallons rontainen Product Type: (per tank or cumulative for by product type) Install Date: Total Capacity this Page: Z gallons Total Capacity for Site: gallons Comments: EHD Inspector: /1 Reviewed Date: By Initial: Entered By Initial: Date: 14 *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