BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMEN' 600 East Main Street,Stockton,CA 95202-302y Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: L k Grp —Lvc. Page 2 Of Facility Addres w City: Inspec on te: ��t �,�v� dr , S rGhr\ ! z oY FA#: Lt PR#: Program Element: 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) f Containers: TA#: 22 `7 (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: Total Capacity: 2 r D gallons (per tank or cumulative for containers by product type) Install Date: T iners (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: ps44 "t Z � Ti-c.tel,(. Total Capacity: ZT o 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) 3 Product Type: Total Capacity: 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) 4 Product Type: Total Capacity: 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: YQ 0 gallons FTotal Capacity for Site: 2 p 3o gallons Comments: EH nspector: Reviewed Date: Entered Date: 1 UA__ By Initial: By Initial: EHD 28-01 01/16/08