BILLING_PRE 2019 - 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 Facilit Name• Y /—V. Page of C;)— Address: n t5 a, City: City: sfi0eFA Inspectio :�Zq #: PR #: Program Element: 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. XTank (2820) ❑ Containers (2821) #of Containers: TA#:� /- 1 Total Capacity: c� % � gallons Product T yp-e`-ug-p d (per tank or cumulative for contai` er�_ptoduct type Install Date: Tank (2820)❑Containers (2821) #of Containers: TA#: 6,o6 LZ $ 2 Total Capacity: a- 5 gallons Product Type: AA OtO� O/ (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: 3- Total Capacity: C� ___ gallons Product Type: A.4 rS�Y 0/ (per tank or cumulative forcontainers by product type) Install Date: XTank (2820) ElContainers (2821) #of Containers: TA#: 4Product Total Capacity: Q a gallons ype: (per tank or cumulative for containers by product type) Install Date: Tank (2820) ElContainers (2821) #of Containers: TAM 5roduc Total Capacity: e Q Q - ga ons tank_or Tt ype: D Y Q/ (per wrr ufaiive�for c3ntainers by product type) Install Date: Total Capacity this Page: e _ 27 gallons Total Capacity for Site: " gallons Comments: EHD Inspector p Reviewed By Initial: Date: 1 Entered /Date: l.'; )�`' )h�i� 1' By Initial: v Aboveground or tank means a alk that has the capacity to store 55 gallons or more of pel-roleum. "Container a a storage device designed to be moved when full. EHD 28-01 09/12/08 AST SURVEY FORM