BILLING - Laserfiche WebLink

Home Browse Search

I - f �/ SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 7� 600 East Main Street, Stockton, CA 95202-3029 ` Telephone: (209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd !i�i ABOVEGROUND PETROLEUM STORAGE.PROGRAM SURVEY FORM Facility Name: n L / j / C)(V pi I N� J A/D` (71S L C., Ci Page / of Facility Address: City: Inspection Dat C7 �I t'J� 'oz , 6 FA#: PR/#: Program Element: 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. Tank (2820) F-1 Containers (2821) #of Containers: TA#: 100 1 Product T Total Ca ) Install Date: ❑ Tank (2820) /containers (2821) #of Containers: TA#: 2Product Type: Total Capacity: ® gallons _ /• /�qA /� (per tank or cumulative for container by product type) Install Date: / W /;--o #of Containers: TA#: 2,93 ❑ Tank (2820) /containers (2821) , --r- 30 Product Type: CSA YTS D 9'y Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Total Capacity: gallons Product Type: (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: U gallons Total Capacity for Site: ro gallons Comments: EHD Inspector: / Reviewed Date: Entered Date: By Initial: � Rjb-�� By Initial: Ea l *Aboveground stora a tank means a tank that has the capacity to store 55 gallons or more of petroleum. "Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08