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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: DA SILVA DAIRY FARMS LLC #2 Page 1 of 7i Facility Address: City: Inspection Date: 24666 E MARISPOSA RD ESCALON 10/23/2013 FA #: PR #: Program Element: FA0020652 2830 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. ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#:a�73� 1Total Product Type: diesel Capacity: � gallons 7 000 for � (per tank or cumulative containers product Install Date: Q Tank (2820) ❑ Containers (2821) #of Containers: TA#: 1�o�D3 2Total Product Type: dyed diesel Capacity: gallons 14,000 #of Containers: TA#:��]c�� ❑X Tank (2820) ❑ Containers (2821) 3 165 Product Type: motor oil Total Capacity: gallons ,{ ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: X026) 4 165 Product Type: hydraulic oil Total Capacity: gallons tank for by type) ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: k6 gip 7-31a 5Total 600 Product Type: used oil Capacity: gallons Install Date: Total Capacity this Page: 21,930 gallons Total Capacity for Site: gallons Comments: DAIRY FARM IS EXEMPT FROM APSA STILL REQUIRED FEDERALLY TO HAVE AN SPCC PLAN EHD Inspector: f . M a N ✓ d Reviewed Date: By Initial: 2u � `b Z -i `1 Entered Date: By Initial: / &� "Aboveground storage tank means a tank that has the capacity to sto a 55 gallons or more of petroleu ""Container means a storage device designed to be moved when full. EHD 28-01 REV 04/19/12 AST SURVEY FORM