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 Facility Na e: 13R age of Facility ddress: /� city: Inspection Date FA#: PR M Pro Eleni nt: 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 tyee. ank (2820) ❑ Containers (2821) #of Containers: TA#: 1 Total Capacity: 9 allons Product Type: (per tank or cumulative for containers by product type) Install Date: ank (2820) ElContainers (2821) #of Containers: TA#: 2 Total Capacity: S�� gallons Product Type: .r (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) U4ntainers (2821) #of Containers: �_ TA#: - 3 .-,�� I Total Capacity: ;�,�gallons Product Type: „•_ _,.•• (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 # ProductType: Total Capacity: gallons - •-- ---- (per tank or cumulative for containers by product type) Install Date: Ll 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: J—S gallons Total Capacity for Site: �� gallons Comments: T 72/ .. f I EHD Inspector: Reviewed Date: Jy� !` Entered Date: By Initial: By Initial: p 1 *Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. 1111 **Container means a storage device designed to be moved when full, � EHD 26-01 09112/08 AST SURVEY FORM