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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.sigov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAU SURVEY FORM <br /> Facility Name: <br /> PG&E Page 1 of 1 <br /> Facility Address: City: Inspection Date: <br /> 4040 West Lane Stockton Jun 15, 2011 <br /> FA#: PR M Program Element: <br /> 6445 527599 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 /> ❑ Tank (2820) Q Containers (2821) <br /> #of Containers: 11 TA#: <br /> 1Total Capacity: gallons <br /> 2,360 Product Type: used oil <br /> (per tank or cumulative for containers by product type) Install Date: <br /> 0 Tank (2820) ❑ Containers (2821) #of Containers: TA#: <br /> 2 Total Capacity: gall <br /> 200 Product Type: motor oil <br /> ons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> X❑ Tank (2820) ❑ Containers (2821) #of Containers: TAM <br /> 3 500 Product Type: hydraulic oil <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank (2820) Q Containers (2821) #of Containers: 1 TAM <br /> 4 55 Product Type:ATF <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> E] Tank (2820) ❑X Containers (2821) #of Containers: 4 TAM <br /> 5 Total Capacity: gall <br /> 220 Product Type: motor oil <br /> ons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> Total Capacity this Page: 3,335 gallons Total Capacity for Site: 3,335 gallons <br /> Comments: <br /> The site capacity does not include oil filled electrical equipment stored at the facility since this <br /> equipment is exempt from the Aboveground Petroleum Storage Act. r <br /> EH eao: Reviewed Date: Entered Date: <br /> By Initial:QJ I By Initial: <br /> Aboveground storage tank means 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 06/03/10 AST SURVEY FORM <br />