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SAN <br /> 4EyLTHDEPART�/if�IT ' <br /> • 600 East Nlaih Street,.Stccktan, CA 95202-3029 <br /> dei nr_o�ae: (209}4bg 3420 w: (209)_463-3433-Web:vr�,�rw.sjgov"ar��ehC <br /> Facilitv Name: /�e / {' Page. -Of <br /> Y"rr ��3 Inspection ate: <br /> : <br /> Facility Address: City, <br /> a a r o as- <br /> FR Program}Elle�mntt:J <br /> FA <br /> T an'k/C ontainer•In#'ormation <br /> Complete for all sites with cumulative aboveground storage of petroleum >_1320 gal-Tons in tanks and containers over 55 gallons. <br /> 1 Complete.one box for each tank or each cumulative container prodact type. } <br /> Tana (2820) [1 Containers {2821-) _"of Containers: TA#: <br /> (>250 gallons) (>55 gallons and<250 gallods) <br /> 1 Product Type: <br /> Total Capacity: gallon's Install Date: <br /> (per tank or cumulative for containers by product type).. <br /> - h <br /> 1 <br />: ❑ Ta±�k (2824) F-1 Containers (2821) - +of Contain rs: - <br /> TAP. ' <br /> >55atto.,s_nd ,250 gaEdo"s) 1 a <br /> a Product Type: <br /> L Total O `=�11pacity: � ans install Date: <br /> (per tank or cumulative for containers by product type) } <br /> . 4 <br /> Tank (2820) El Containers (2821) rtof Containers: TAS:. <br /> (>250 gallons) (>55 gallons and"<250 gallons) <br /> 3 Product Type: <br /> Total Capacity: gallonsi 2 <br /> (per tan&or cumulative for containers by product type) <br /> 15ta1' Ditt : a <br /> El Tank (?S20) L] C,Qneainers {2321) -a-of f-OTtaireT5: , — 3' <br /> x >55 pallor_..9 sand,�254,�lloas,g ) 1. <br /> ( T]« du c '7 P B <br /> 1 1 Iota! P-P-acitr1; via•i'1- <br /> 3 i��'r tan::or eurr.ulauve`e,contatizers.by :roducf-type; . <br />` 1 - -- <br /> . IL-Ag' <br /> A g. <br /> Ta: 2920J LE rozA0 �CiCa _ <br /> >25t °a 19P5) <br /> " <br /> 1? g_ii lis and<250�ali0i' j _ e <br /> _L'ri3d-of 7 -ver <br /> r E } i.._Gl_ vG_-C°_�t fi_ <br /> �.3 <br /> at�i: - <br /> i fo;coneLic.s b,:rrodu..:ty <br /> r� .rt .,��-.,_.=.•.M��-r^�.1.J V 'y = �.�,...,.�.,...,.._... --`--'�-;�'-' �,5.-R---'---�.i�,� .,...•� ,,, ---^T :lli f�1'� j <br /> l-....N - __ _ •,--S.Yi3ir,5'3 7'�`•=': .Y�� s:- S�Js" �:- � �� `" ,..a <br /> t;=..,.r ..� ,.�i�i+"`"^.�r;�� �...._,..__ __,•.4_W_,,......�..._e....�,.. �._....o._...=e..».r_,.-,._.�...:�--..•-.�---- [i IIII�� j <br /> i <br /> z11S <br /> ` � 4 <br /> Reviewed Date: Entercd Date: <br /> EHD Inspector: r 1�� � 0� By loivaL i <br /> By hritiaL \ }tj�V 1 _ <br /> EH 23-U 1 <br />