BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY �. ENVIRONMENTAL HEALTH DEPARTMEN- .,00 East Main Street,Stockton,CA 95202-30- Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: �- ' o Page of Facility Address: City: Inspectio Da 13 U o F(,A�A � -Tl?-6 C-y FA#: PR#: Progr m Element: o0jog 89 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum z 1320 gallons in tanks and containers over 55 gallons. Complete one box for each tank or each cumulative container product type. ❑ Tank(2820) ontainers (2821) #of Containers: . / TA#: On &q,-)7 (>250 gallons) (>55 gallons and<250 gallons) 1 /� Product Type: 0 /, Total Capacity:/ gallons Install Date: (per tank or cumulative for containers by product type) ❑ Tank (2820) Containers (2821) #of Containers: 3 TA#: Z955-LP (>250 gallons) (>55 gallons and<250 gallons) 2 ej;- I C) Product Type: r� y Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) L?'Containers (2821) #of Containers: TAM ae-5�7 (>250 gallons) (>55 gallons and<250 gallons) �. 3 170 Product Type: Total Capacity: `y 6 gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Ce Containers (2821) #of Containers: �TA#: /2 6J- 4 (>250 gallons) (>55 gallons and<250 gallons) 4 2-7 b Product Type: D/ Total Capacity: gallons (per tank or cumulative for containers fay product type) Install Date: E�Tank(2820) ❑ Containers (2821) #of Containers: TAM (>250 gallons) (>55 gallons and<250 gallons) 5 �o Product Type: a/ Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: ((Z C, gallons Comments: J /� . 0 EHD Inspector: , Reviewed w Date: ,/ Entered te: By Initial: IZA'0` By Initial: (J (l EHD 28- 01/16/08