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0 0 <br /> 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 /> Universal Sweeping Services Page 1 of 1 <br /> Facility Address: City: Inspection Date: <br /> 1113 N. Shaw, Stockton Stockton May 6, 2011 <br /> FA M PR#: Program Element: <br /> FA0003565 2831 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks*and containers**. <br /> Complete one box for each tank or each cumulative container product type. <br /> ❑X Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> 1Total Capacity: gallons <br /> 2,000 Product Type: diesel <br /> (per tank or cumulative for containers by product type) Install Date: unknown <br /> X❑ Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> 2 Product Type: used oil <br /> Total Capacity: 350 gallons <br /> (per tank or cumulative for containers by product type) Install Date: unknown <br /> X❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 3 Product Type: hydraulic oil <br /> Total Capacity: 350 gallons <br /> (per lank or cumulative for containers by product type) Install Date: unknown <br /> ❑X Tank (2820) ❑ Containers (2821) #of Containers: TAM DS aD2 3 <br /> q Product Type: motor oil <br /> Total Capacity: 350 gallons <br /> (per tank or cumulative for containers by product type) Install Date: unknown <br /> ❑ Tank (2820) ❑X Containers (2821) #of Containers: 1 TA#: a <br /> 5Product Type: hydraulic oil <br /> Total Capacity: 55 gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: 3,105 gallons Total Capacity for Site: 3,105 gallons <br /> Comments: <br /> EHD Insp or: Reviewed Date: Entered Date: <br /> By Initial: 1/rJ •"j.q't 1 By Initial: 1 <br /> *Aboveground age tank ns a tank that has the capacity to store 55 gallons or more of petroleum. <br /> "Container means a storage device designed to be moved when full. <br /> EHD 28-01 REV 08/03/10 AST SURVEY FORM <br />