BILLING - Laserfiche WebLink

Home Browse Search

SAN JOAQUIN COUNTY Jr INVIRONMENTAL HEALTH DEPARTMENT * _J0 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 T I� a,21 Facility Address: City: Inspectio Da : o ,PGAzA T�/q C-9 D FA#: PR#: Progr m Element: 0010989 C2 -"?_33 253 ) 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. ❑ Tank(2820) ontainers (2821) #of Containers: TA#: O51 0,-)7 (>250 gallons) (>55 gallons and<250 gallons) 1 Product Type: (j Total Capacity: /1146 gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) Containers (2821) #of Containers: 3 TA#: Sj LP l aC (>250 gallons) (>55 gallons and<250 gallons) 2 Product Type: p ly Total Capacity: 3 to gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) LA'C ontainers (2821) #of Containers: TA#: Off( i� (>250 gallons) (>55 gallons and<250 gallons) 3 'L t -a> Product Type: Total Capacity: l` gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank(2820) Ee Containers (2821) #of Containers: - JTA#: (>250 gallons) (>55 gallons and<250 gallons) L./ 4 Product Type: D/ Total Capacity: gallons (per tank or cumulative for containers tay product type) Install Date: C!f Tank(2820) ❑ Containers (2821) #of Containers: TA#: (>250 gallons) (>55 gallons and<250 gallons) ��"" 5 Product Type: //�')qj7f' a/ Total Capacity: 0 gallons (per tank or cumulative for containers by product type) Install Date: /' Q Total Capacity this Page: f' gallons Total Capacity for Site: ! © V gallons Comments: EHD Inspector: ` Reviewed Date: �f Entered Date: By Initial: Vv'- By Initial: y n D EHD 28-01 01/16/08