BILLING_PRE 2019 - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTME. 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 Name* ,n -C i^�1/c C�0 li 5 Z j Page of i'U/d Facility Address: //�� ry W/r��ll/V �j1J/'/{j City: Y- J Inspection o V �V FA Q( PR #: D 5a �Cece� Program Element: 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. EY/Tank(2820) ❑ Containers (2821) #of Containers: TA#: N5—L7 A11 3 1 (>250 gallons) (>55 gallons and <250 gallons) . Product Type: xO`�Oi�- O/& Total Capacity: Z gallons Install Date: (per tank or cumulative for containers by product type) .41 Tank (2820) ❑ Containers (2821) #of Containers: TA#: Qom) 74/ 2 (>250 gallons) (>55 gallons and <250 gallons) l ' Product Type: /LIl>f61& 0 t'(../ Total Capacity: ?/rO gallons Install Date: (per tank or cumulative for containers by product type) ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 (>250 gallons) (>55 gallons and <250 gallons) Product Type: _ Total Capacity: gallons Install Date' (per tank or cumulative for containers by product type) -- ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 (>250 gallons) (>55 gallons and <250 gallons) Product Type: � Total Capacity: gallons Install Date: (per tank or cumulative for containers by product type) ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 (>250 gallons) (>55 gallons and <250 gallons) Product Type: Total Capacity: gallons Install Date: (per tank or cumulative for containers by product type) Total Capacity this Page: ® gallons Total Capacity for Site: gallons Comments: d EHD Inspector: m Reviewed Date: Entered Date: By Initial: By Initial: 0 EHD 28-01 01/16/08