Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <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 /> D/.D +I' V Page of <br /> Facility Address: City: Inspe tion Date: <br /> FA#: PR#: Pro am Element: <br /> v vsi S <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 e. / <br /> KTank(2820) ❑ Containers (2821) #of Containers: TA#: �G D�AD,T 9 <br /> 50 gallons (>55 gallons and<250 gallons) ���n��� � <br /> 7?(o - Product Type: '^1 <br /> Total Capacity: llons p <br /> (per tank or cumulative for contain s by product type) Install Date: 1-/ -7k <br /> Tank(2820) ❑ Containers (2821) of Containers: TA#: _ <br /> (>2 allons) 5 gallons and<250 gallons) <br /> 2 Pro Type: 1. <br /> Total Cap ty: 2 allons Install Dat <br /> (per tank or cumula or containers by product <br /> to Tank(2820) ❑ Containers (2821) #of Containers: TA#: ����jj�h�•Lgg <br /> (>250 gallons) (>55 gallons and<250 gallons) n �/ � <br /> 3 bS2 9--7- Product Type: F L-)'z <br /> Total Capacity: gallons Install Date: <br /> (per tank or cumulative for containers by product type) ./ <br /> Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> (>250 gallons) (>55 gallons and Q50 gallons) ju 6 # 700 <br /> 4 CP�(P F 20 Product Type: �Q� V <br /> Total Capacity. gallons / O <br /> (per tank or cumulative for contain by product type) Install Date: J <br /> Tank (2820) ❑ Containers (282 1) #of Containers: TA#: <br /> 250 gallons) (>55 gallons and<250 gallons) <br /> 5 Product Type: L ver <br /> Total Capacity: L4 10 Z gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: ]lons Total Capacity for Site: - gallons <br /> Comments: <br /> 5 1/ <br /> EHD Inspect wed Date: Entered Date: <br /> By Initial: By Initial: <br /> EHD 28-01 <br /> 01/16/08 <br />