BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY - ' ENVIRONMENTAL HEALTH DEPARTMENT 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: Page of rT- Facility Address:. City: Inspection° Z P- 1,, 6 O D b FA#: PR#: Program E Tank/Container Information Complete for all sites with cumulative aboveground storage of petroleum 21,320 gallons in tanks`and containers"". Complete one box for each tank or each cumulative container product type. ank (2820) ❑ Containers (2821) #o#Containers: TSA#: 1 Total Capacity: �� gallons Product Type: (per tank or cumulative for containers by product type) Install Date: L5" Tank (2820) 1:1Containers (2821) #of Containers: TA#: 28 allons Product Type: Total Capacity: �-� g (per tank or cumulative for containers by product type) Install Date: 94�ank (2820) ElContainers (2821) #of Containers: TA#: 3 - Product Type: Ppw- Total Capacity: gallons �� (per tank or cumulative for containers by product type) 'Install Date: ElTank (2820) 2 Containers (2821) #of Containers: TA#: 4 I� Product Type: �tv f° . Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ElTank (2820) #of Containers: TA#.Containers (2821) 5 " r Product Type: _ Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: gallons Total Capacity for Site: ��/ gallons Comments: L � s EHD Inspector: Reviewed i Date: Entered Date: By Initial: t t A By Initial: B 'Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. 7Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08