Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM" <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/ehd <br />ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM <br />Facility Name: <br />xPage <br />_L_ ofy <br />Facility Addres � � � � City: t�� <br />s' l S l/ — <br />Inspection at <br />717-110 <br />FA #: <br />D �I <br />PF1 #: <br />o5 5 7 D <br />Program Element: <br />2-9 3 -� <br />Tank/Container Information <br />Complete for all sites with cumulative aboveground storage of petroleum >_ 1320 gallons in tanks and containers over 55 gallons. <br />Complete one box for each tank or each cumulative container product type. <br />Tank (2820) ❑ Containers (2821) #of Containers: TA#: ��rj / Ir/ <br />1 <br />(>250 gallons) (>55 gallons and <250 gallons) p <br />v f a Product Type: <br />Total Capacity: Z d gallons �� _ <br />Install Date: <br />(per tank or cumulative for containers by product type) <br />❑ Tank (2820) P16ritainers (2821) #of Containers: TA#: <br />2 <br />(>250 gallons) (>55 gallons and Q50 gallons) Product Type: 411 hrJe <br />Total Capacity: S S 0 gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />❑ Tank (2820) 517 ontainers (2821) #of Containers: TA#: /95) le Lo ( % <br />3 <br />(>250 gallons) (>55 gallons and <250 gallons) / <br />Product Type: (� l [� <br />Total Capacity: Z 5 d gallons <br />Install Date: <br />(per tank or cumulative for containers by product type) <br />❑ Tank (2820) Containers (282 1) #of Containers: TA#: Z2 5/ %& <br />4Product <br />(>250 gallons) (>55 gallons and <250 gallons) <br />Type: O/ <br />Total Capacity: / G .� gallons <br />Install Date: <br />(per tank or cumulative for containers by product type) <br />❑ Tank (2820) Containers (2821) #of Containers: TA#: <br />5 <br />(>250 gallons) (>55 gallons and <250 gallons) <br />Product Type: A✓�'/ /'�2 F � zF <br />_,Q <br />Total Capacity: / Id gallons <br />Install Date: <br />(per tank or cumulative for containers by product type) <br />Total Capacity this Page: ZQ i gallons <br />Total Capacity for Site: 7i09 gallons <br />Comments: 1114. G _ 1qNG-'Le <br />EHD Inspector: <br />Reviewed <br />Date: <br />Entered Date: <br />v/ <br />By Initial: <br />�� <br />By Initial: q <br />EHD 28-01 <br />01/16/08 <br />