COMPLIANCE INFO PRE 2019 - 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 ame: /� A pojvla- Page r�. of Facility Address:l�Jl V City: Inspection Date: U V1�.ni a FA 0 6PR : D 1;-19 -7q' � � � � Program Element: a2- 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. --f❑ Tank (2820) ❑ Containers (2821) #of Containers: TA#: 1 Product Type: 0%1 Total Capacity: �(�_gallons Install Date: ,❑D'Tank (2820) ❑ Containers (2821) #of Containers: TA#: 2 Product Type: 4 0 GWI,S Total Capacity: 1506� gallons _ (per tank or cumulative for containers by product type) '(, Install Date: O'Tank (2820) ❑ Containers (2821) #of Containers: TA#: 3 g Product Type: Total Capacity: b allons (per tank or cumulative for containers by product type) Install Date: ,2-Tank (2820) ❑ Containers (2821) #of Containers: TA#: 4 Product Type: Total Capacity: gallons (per tank or cumulative for containers by product type) Install Date: ❑ Tank (2820) Z-Containers (2821) #of Containers: TA#: 5 Total Capacity: ,;LO gallons Product Type: II - �Cp�✓�Wl� i Uv► FtU�� (per tank or cumulative for containers by product type) F Insfail Date: ✓✓ Total Capacity this Page: gallons Total Capacity for Site: gallons Comments: EHD Inspector: Reviewed Date: Entered Date: By Initial: By Initial: "Aboveground 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 09/12/08 AST SURVEY FORM