BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

or SAN JOAQUIN COUNTY T VIRONMENTAL HEALTH DEPART Na r, 00 East Main Street, Stockton,CA 00 GE Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd /1/lr , ABOVEGROUND PETROLEUM STORAGE PROGRAM SURVEY FORM Facility Name: 3 L4 '0 N� / F V/J-rX 16 t/72,0n/ Page � of Facility Address: City: Inspect'o Date• 2 S• n/ A t 7zr� x FA#: PR#: Program Element: vO I o3> 05 Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum >1320 gallons in tanks and containers over 55 gallons. Complete one box for each tank or each cumulative container product type. IR/Tank (2820) ❑ Containers (2821) #of Containers: TA#: 195/&196-,& (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: Total Capacity: l Z c3 4T-6 gallons 85z (per tank or cumulative for containers by product type) Install Date: 1?XTank(2820) ❑ Containers (2821) #of Containers: TA#: X61 Le 66-7 (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: Total Capacity: /Z.4O gallons lcszafier ! (per tank or cumulative for containers by product type) Install Date: Tank(2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) 3 Product Type: Total Capacity: /Z d o b gallons (per tank or cumulative for containers by product type) Install Date: (2820) )��gallons ontainers (2821) #of Containers: TA#: !' *(150gallons) and<250 gallons) 4 Product Type: J,//a, STl O l Total Capacity: 5gallonsloGct}j�n VV (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 allons and<250 gallons) 5 Product Type: Total Capacity: d gallons (per tank or cumulativ or contain r uct type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: gallons Comments: D EHD Inspector: RevLDat iewed e1 Entered Date: r By Initial: / By Initial: a26 O EHD 28-01 01/16/08