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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: Tracy Ford Page 1 of 2 Facility Address: City: Inspection Date: 3500 Auto Plaza Way Tracy Jun 13, 2011 FA#: PR#: Program Element: 0010988 0528233 2831 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. ❑X Tank (2820) ❑ Containers (2821) tainers: TA#: 1 Total Capacity: gallons 1,000 Product Type: used oil (per tank or cumulative for containers by product type) Install Date: Oil Room Tank (2820) ❑ Containers (2821) #of Containers: TA#: - 6 11Wc3 2Total Capacity: gallons 240 Product Type: 5W-20 (per tank or cumulative f ners by product type) Install Date: Oil Room ❑X Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 120 Product Type.ATF Total Capacity: gallons cumulative for containers by product type) Install Date: Oil Room ❑ Tank (2820) ❑X Containers (2821) #of Containers: 2 TA#: 295,20,5;2_ 1 4110 Product Type: Waste gas/diesel fuel Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: northeast Service Dept ❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 5 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: Total Capacity this Page: 1,470 gallonsTotal Capacity for Site: (, gallons Comments: EHD Inspector: Reviewed Date: (iI Entered Date: By Initial: ` 11 By Initial: * bovegrodnd storage 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 REV 06/03/10 AST SURVEY FORM