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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 sjgov.org/ehd <br /> ABOVEGROUND PETROLEUM STORAGE PROGRAM 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#: Program Element: <br /> 6445 527599 2831 <br /> Tank/Container Information <br /> Complete for all sites with cumulative aboveground storage of petroleum 2_1,320 gallons in tanks' and containers— <br /> Complete <br /> ontainers"Com lete one box for each tank or each cumulative container product type. <br /> ❑ Tank (2820) X❑ Containers (2821) #of Containers: 11 TA#: �iTO <br /> 2,360 <br /> Total Capacity: gallons Product Type: used oil <br /> (pertank orcumutatrve forcontainers by product type) Install Date: <br /> X❑ Tank (2820) F-1 Containers (2821) <br /> #of Containers: TA#: 7O <br /> 2Total Capacity: 200 gallons Product Type: motor oil <br /> (pertank or cumulative for containers by product type) Install Date: <br /> ❑X Tank (2820) ❑ Containers (2821) #of Containers. TA#: i95o',j05 <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) X❑ Containers (2821) #of Containers TA#: B SoU 7D(e <br /> 4 55 Product Type: ATF <br /> Total Capacity: gallons <br /> (per tank or cumulative for containers by product type) Install Date: <br /> ❑ Tank (2820) X❑ Containers (2821) #of Containers: 4 TA#: 1�,ho7D2/9� <br /> 5220 Product Type: motor oil <br /> Total Capacity: gallons <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. <br /> EH cto Reviewed Date:, Entered Date: <br /> By Initial:2J 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 /> EHO 28-01 REV 06/03110 AST SURVEY FORM <br />