BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMEN' o00 East Main Street,Stockton,CA 95202-30ij Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: 1 [ S- l� Page of � Facility Address: City: Inspectio Date: ,5� W 7�i d FA#: R#: Program Element: 0 3 2y3y Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >1320 gallons in tanks and containers over 55 gallons. Complete one box for each tank or each cumulative container product type. Tank (2820) ❑ Containers (2821) #of Containers: " T 1 7 DaZ`Z (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: Total Capacity: /,0 p C gallons (per tank or cumulative for containers by product type) Install Date: Tank(2820) ❑ Containers (2821) #of Containers: TA#: 426 7Da2� (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: i^-I o T-o l9_ 0 /(-,) Total Capacity: -3 d gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: ��j 1 7/�� (>250 gallons) (>55 gallons and<250 gallons) 3 Product Type: 410 j0/Z 0,f Total Capacity: Q " gallons (per tank or cumulative for containers by product type) Install Date: E!TZTank (2820) ❑ Containers (2821) #of Containers: TA#: e9z9 (>250 gallons) (>55 gallons and<250 gallons) 4 Product Type: 1'/J S Total Capacity: 3 U b gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: Jl 7 D gallons Total Capacity for Site: ��3 (� D gallons Comments: EHD Inspector: Reviewed Date: Entered Date: / By Initial: ��1� f� By Initial: • EHD 28-01 J 01/16/08