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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br />Facility Name: <br />Crop Production Services <br />Page 1 of 2 <br />Facility Address: <br />City: <br />Inspection Date: <br />1905 N. Broadway, Stockton <br />Stockton <br />June 24, 2011 <br />FA #: <br />PR #: <br />Program Element: <br />FA0010413 <br />5c� <br />2831 <br />Tank/Container Information <br />Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks* and containers". <br />Complete one box for each tank or each cumulative container product type. <br />Tank(2820) ❑Containers (2821) <br />X Tank 2820 <br />#of Containers: <br />TA#: a zB a 9� <br />1 <br />Product Type: used oil <br />750 <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />X❑ Tank (2820) ❑ Containers (2821) <br />#of Containers: <br />TA#: X961-zq a �p <br />2Total <br />300 <br />Product Type: motor oil <br />Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />X❑ Tank (2820) ❑ Containers (2821) <br />#of Containers: <br />TA#: ,5?5j2zP � <br />3 <br />Product Type: hydraulic oil <br />300 <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />X❑ Tank (2820) ❑ Containers (2821) <br />#of Containers: <br />TA#:45o2,5,2,3 <br />4 <br />Product Type: ATF Oil <br />300 <br />Total Capacity: gall ons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />#of Containers: <br />TA#: 1_z9q <br />X❑ Tank (2820) ❑ Containers (2821) <br />5 <br />300 <br />Product Type: motor oil <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) <br />Install Date: <br />Total Capacity this Page: 1,950 <br />gallons <br />Total Capacity for Site: <br />2,280 gallons <br />Comments: <br />Aboveground tanks are located on 1755 N. <br />Broadway, but business location is 1905 Broadway. The <br />two addresses are on one contiguous lot. <br />EHD Inspecto <br />Reviewed '__ II Date: <br />By Initial: !/Vr" 10 •'j.ti' (� <br />Entered n Date; l <br />By Initial: (\/ L/f• <br />" Cjvegro ge tank rhea s a tank that has the capacity to store 55 gallons or more of petroleum. <br />'*Contain ns a storage de ce designed to be moved when full. <br />EHD 28-01 REV 06/03 10 AST SURVEY FORM <br />