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 ility Name: ility Address:L_Uam FA #. City: Page YJ of on Progr Tank/Container Information7 7�_ 7 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. ❑ Tank (2820) Containers (2821) #of Containers: T,A�#: 6j G� 71 1 Product Type: L Q, f Total Capacity: I � gallons i�- �l4 ,(,f, (per tank or cumulative for containers by product type) Install Date: YTank (2820) ❑ Containers (2821) #of Containers: TA#:/�Q `70� 4 Product Type: seri J)J � a rl Total Capacity: gallons (per tank or cumulative for containers by product type) l e s Install Date: �t/1 x Tank (2820) ❑ Containers (2821) #of Containers: TA#: if 5_1 q '� � 5 `` Product Type: G� Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: S gallons Total Capacity for Site: gallons Comments: EHD Inspector: Reviewed Date: Entered By Initial: By Initial: *Above§round st'ge tank means a tank that has the capacity to store 55 gallons or more of petroleum. "Container means a storage device designed to be moved when full. EHD 28-01 09/12/08 AST SURVEY FORM ['Tank (2820) El Containers (2821) #of Containers: TA#: ASS/ q -7) 9' 2Product Total Capacity: gallons Type: Will WA -o- W Le j�uaI e I (per tank or cumulative for containers by product type) , ' ,,� '! Install Date: w�`�_ NK Tank (2820) El Containers (2821) #of Containers: TA#: �h Cr `7 ,0 -/ 3� Total Capacity: gallons Product Type: ShEl l DJ ,) G1 AY 01 � (per tank or cumulative for containers by product type) Install Date: YTank (2820) ❑ Containers (2821) #of Containers: TA#:/�Q `70� 4 Product Type: seri J)J � a rl Total Capacity: gallons (per tank or cumulative for containers by product type) l e s Install Date: �t/1 x Tank (2820) ❑ Containers (2821) #of Containers: TA#: if 5_1 q '� � 5 `` Product Type: G� Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: S gallons Total Capacity for Site: gallons Comments: EHD Inspector: Reviewed Date: Entered By Initial: By Initial: *Above§round st'ge tank means a tank that has the capacity to store 55 gallons or more of petroleum. "Container means a storage device designed to be moved when full. EHD 28-01 09/12/08 AST SURVEY FORM