BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTME1 600 East Main Street,Stockton,CA 95202-3029 Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Nam- /•/✓��la/�f� �Q�'��t�J3 �� •Page L—of� Facility Address: , Inspect'' Date i 41-CG k FA#: PR� 9S3 � � Pro m�le nt: 5 1 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum z 1320 gallons in tanks and conta�ver 55 gallons. Com ete one box for each tank or each cumulative container product type. 2820) Containers (2821) #of Containers: '3 TA#: o,6 'ZP3-B (>250 gallons) (>55 gallons and<250 gallons) 1 l � J Product Type: /�//�_f � 0/ Total Capacity: J gallons ;�y, (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Ze ontainers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) // / 2 Z o� Q L �/ P 1 L/ Total Capacity: gallons (�,1 �,� =c;l c ra j2 - (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Ly"Containers (2821) #of Containers: _ 1 >250 gallons) (>SS gallons and<250 gallons) 3 ( Product Type: J Total Capacity: gallons` ; (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Containers ( rs: TA#: (>250 gallons) (>55 gallons and<250 gall' s) � 4 ( Product Type: Total Capacity: �V gallons � 6�: 6�1 qZ-M* 2-41 (per tank or cumulative or containers by product type) Install Date: j -- ❑ Tank (2820) on amens (2821) #of Container : A#: l9`J' a�D (>250 gallons) (>55'gallons and<250.gallons) 5 ' '1 p Product Type: Total Capacity: g�llons a N: r �0 111 (per tank or cumulative foi containers by prodw type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: gallons Comments: ZO -20 M- qllfllf 93a EHD Inspector: Reviewed Date: Entered Date: s By Initial: VVTj By Initial: D EHD 28-01 (Zug- q 13 \� 01/16/08