BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMEI 600 East Main Street, Stockton, CA 95202-3019+ Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FqRM 0 Facility Name: C)`(/ 's Page of Facility Addr s: V I ! v . .S G Vz l � City: Inspect* a Date z'� FA #: PR #: Program Element: Tank/Container Information Comple or all sites with cumulative aboveground storage of petroleum Z 1320 gallons in tanks and containers over 55 gallons. -Complete one box for each tank or each cumulative container product type. (2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and <250 gallons) 1 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: (2820) VContainers (2821) t #of Containers: TA#: D�l �Og Zns) 2 (>55 gallons and <250 gallons) '3D / Product Type: Total Capacity: gallons al (i (per tank or cumulative for containers by product type) Install Date: 2820)ontainers (2821) Wank(2820)/M. #of Containers: TA#: (>250 gallons) (> gallons and <250 gallons) 3 Product Type: Total Capacity: 6WW— gallons (per tank or cumulative for containers y product type) Install Date: 2820) ntainers (2821) *(>2510gallo�) #of Containers: TA#: (>55 gallons and <250 gallons) 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers product type) Install Date: (2820) Containers (2821) #25 #of Containers: TA#: gallons) (>55 gallons and <250 gallons) \5 Total Capacity: 42;�tg S S gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: gallons Comments: EHD Inspector: Reviewed Date: Entered Date: By Initial: By Initial: EHD 28-01 01/16/08