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 Facillt Name: Page of Facili Address: City: Inspe tion Date: C44 f-/ol 4r � � is /o FA#: PR#: Prog m Element: / 04 2 Lt �z�6 ZZZ 2 X40 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks' and containers- Complete ontainers-"Com lete one box for each tank or each cumulative container product type. ,NrTank (2820) ❑ Containers (2821) #of Containers: TA#: S 16, S -7 9 1 Product Type: Total Capacity: ?jS o gallons (per tank or cumulative for containers by product type) Install Date: ;R Tank (2820) ❑ Containers (2821) #of Containers: TA#: 15 6 g 8�c7 2 Total Capacity: gallons Product Type: (per tank or cumulaFve for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: El Tank (2820) El 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: SO gallons Total capacity for Site: 5 S; gallons Comments: Fac ( ko S s EHD Inspector Reviewed Date. Entered Date: By Initial: y,'}'tr,t J By Initial. ¢ / Abovegro d storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. l "`Container means a storage device designed to be moved when full. EHD 28-01 09/12/08 AST SURV.