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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: O 6- lvf A e Jo A/ 3 C�l�� Page of Facility Address: City: / Inspection D e: /✓ N TGG Oil, 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. E�'Tank (2820) El Containers (2821) #of Containers: TA#: 5 13 -S`- 0 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: 51 ank (2820) ❑ Containers (2821) #of Containers: TA#: 2Total Capacity:p y gallons Product Type: /7S (per tank or cumulative for containers by product type) Install Date: ank (2820) ❑ Containers (2821) #of Containers: TA#: 3 .2 Product Type: Total Capacity: l7 C2 �gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) M/Con�iners (2821) #of Containers: TA#: o2Vr 4 �� lrI 0� Total Capacity: � � gallons Product Type: (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Containers (2821) #of Containers: TA#: / a 5 Total Capacity: � � gallons Product Type: D (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: `� f gallons Total Capacity for Site: d , gallons Comments: /v I S 0 6 D EHD Inspector: Reviewed , ' ^I Date: Entered Date: By Initial: Vim' By Initial: �I `Aboveground storage tank means a tank that has the capacity to store 55 gallons or more of petroleum. o� "Container means a storage device designed to be moved when full. EHD 28-01 AST SURVEY FORM 09/12/08