Laserfiche WebLink
DEPARTM <br /> 202-"East MainSAN StreeJOt,AQOIN StocktonCOUN,CATY 95202- <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 /> J,/ C_ v Page Z of,3-- <br /> Facility Address: City: tuspe DateY/� <br /> (5 2S <br /> FA#: PR#: Program Element- <br /> OL 1 <br /> lement:a.sl q 7 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum 21320 gallons in tanks and containers over 55 gallons. <br /> Complete one box for each tank or each cumulative container product type. <br /> Tank(2820) ❑ Containers (2821) #of Containers: TA#: _ 05/le 73 <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 1 Product Type: 4Lf? ,-/2i L <br /> Total Capacity: L)0 gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Tank(2820) ❑ Containers (2821) #of Containers: TAM /9 / le 7.3 <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 2 Product Type: �VA $�� 6L � <br /> Total Capacity: 7j o D gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> t1d "lank (2820) ❑ Containers (2821) #of Containers: TA#: ��lle��j o2 <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 3 Product Type: � O e. <br /> Total Capacity: 10 a gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank(2820) Containers (2821) #of Containers: 4 TA#: 426-1(� 7�3 <br /> (>250 gallons) (>55 gallons and<250 gallons) <br /> 4 Product Type: Am/ ?'� A�//CA,6�Z G <br /> Total Capacity: /000 gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Tank(2820) ❑ Containers (2821) #of Containers: TA#: <br /> (>250 gallons) (>55 gallons and<250 gallons) _ <br /> 5 Product Type: <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: Z�4U gallonsTotal Capacity for Site: gallons <br /> Comments: <br /> EHD Inspector: Reviewed Date: Entered Date: <br /> By Initial: By Initial: D D <br /> EHD 28-01 <br /> 01/16/08 <br />