Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <br /> 600 East Main Street,Stockton,CA 95202-302Y ` <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br /> FacilityNan e: <br /> Page of <br /> Facility Address: City: Inspection Dat _ <br /> TRS ®i�6 ZODI <br /> FA#: PR#: Program Ele ent: <br /> 117M e612 _Z_ g 'Z� r <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum z 1320 gallons in tanks and containers over 55 gallons. <br /> Complete one box for each tank or each cumulative container product type. <br /> Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 1 r Product Type: <br /> Total Capacity: J 0 Ca gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Ir'"Tank(2820) ❑ Containers (2821) #of Containers: TA#: Q,5/74 0 <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 2Product Type: _��(�� <br /> Total Capacity: S 0© gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ank(2820) ❑ Containers(2821) #of Containers: T kM ��¢ <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 3Product Type: _a4 eta/ <br /> Total Capacity: � gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> 15 Tank(2820) ❑ Containers (2821) #of Containers: TAM <br /> (>250 gallons) (>55 gallons and<250 gallons) �7 <br /> 4 Product Type: t�4 � ,� <br /> Total Capacity: So 6 gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 5 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: ,� &2 gallons Total Capacity for Site: 'Z_0 0 0 gallons <br /> Comments: <br /> EHD Inspector: Reviewed Date: Entered Date: <br /> • By Initial: .}•t)`� By Initial: <br /> EHD 28-01 <br /> 0(/16/08 <br />