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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <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 />Owens Brockway <br />Page of <br />Facility Address: <br />City: <br />Inspection Date: <br />14700 West Schulte Road <br />Tracy�2,,2QQ$. <br />FA #: <br />FPR #: <br />Program Element: <br />0006674 <br />10516327 <br />2832 <br />Tank/Container Information <br />Complete for all sites with cumulative aboveground storage of petroleum >_1,320 gallons in tanks* and containers". <br />Complete one box for each tank or each cumulative container product type. <br />#of Containers: TA#: 0516077 <br />X❑ Tank (2820) F1 Containers (2821) <br />1Product <br />Type: diesel <br />Total Capacity: 1,000 L gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />#of Containers: TA#: 0516078 <br />X❑ Tank (2820) F] Containers (2821) <br />2Total <br />450 Product Type: used oil <br />Capacity: _ gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />#of Containers: TA#: 0516079 <br />❑X Tank (2820) ontainers (2821) <br />3 <br />1 750 Product Type. used oil <br />Total Capacity: gallons <br />(per tank or cumulative for containers y product type) Install Date: <br />#of Containers: TA#: 0516080 <br />c� Tank (2820) ❑Containers (2821) <br />4 <br />180 Product Type: diesel <br />Total Capacity: gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />#of Containers: TA#: 0516081 <br />W Tank (2820) D Containers (2821) <br />5/'180 <br />Product Type. diesel <br />Total Capacity: <br />gallons <br />(per tank or cumulative for containers by product type) Install Date: <br />Total Capacity this Page: 3,560 gallons <br />Total Capacity for Site: 1+ gallons <br />Comments: <br />C- <br />7 y UI Z 6 <br />EHD Inspector: <br />Reviewed Date <br />By Initial: ` <br />Entered Date: <br />By Initial: <br />`Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. t 1 <br />—Container means a storage device designed to be moved when full. <br />V <br />EHD 28-01 REV 06/03/10 AST SURVEY FORM <br />