BILLING - 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 Facility Name: G Page of Facility Address: City: 7 5 6 vj6; Inspecti0 Da 10q FA M f 7 PR #: Program lem nt: 2g10 Tank/Container Information 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. 13"Tank (2820) ❑ Containers (2821) #of Containers: _ TO: �l aD 1 Product Type: Total Capacity: / p 0 6gallons (per tank or cumulative for containers by product type) Install Date: Tank (2820) ElContainers (2821) #of Containers: TA#: 2 Product Type: 4Zi4 i Z� 19"o � Total Capacity: (t -U gallons (per tank or cumulative for containers by product type) Install Date: #of Containers: TA#: lib 1 190& Ly' Tank (2820) ElContainers (2821) 3 Product Type: gallons Total Capacity: g (per tank or cumulative for containers by product type) Install Date: ��y,✓� #of Containers: TA#: Tank (2820) ❑ Containers (2821) 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers15y product type) Install Date: ,�/✓''"/�Z/ V ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 'L fl� gallons Total Capacity for Site: 2 gallons Comments: 2v , �J EHD Inspector: Reviewed 1 ' �I Date: By Initial: o' t� 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