BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY r 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 Facility Name: 6-t %S Page —Lof�— Facility Address:City: /7 c� 0 C S 1 i9 A tvC 14 y� Inspection e: %� � 0 C' FA #: PR #: Program Element: Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum ?1,320 gallons in tanks* and containers**. Complete one box for each tank or each cumulative container product type. VTank(2820) ❑ Containers (2821) #of Containers: TA#: /96-) c3 �g 1 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: /Tank(2820) 2 ❑ Containers (2821) Product Type: Total Capacity: .� gallons —� (per tank or cumulative for containers by product type) Install Date: iZ/Tank(2820) ❑ Containers (2821) #of Containers: TA#: 3 /-' Product Type: l-'"�S S` Total Capacity: �-2 gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 O Product Type: Total Capacity: ZOgallons / (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) '#of Containers: TA#: 5 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: 3 (% gallons Comments: r 1-49 COS T)q Lfz-O — 0 6 I EHD Inspector: 5 t Reviewed` - Date: By Initial: /'1 t o •- I A Entered Date: By Initial: *Aboveground storage 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 AST SURVEY FORM 09/12/08