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INVENTORY RECONCILIAT' 1,_, <br />QUARTERLY SUMMARY RF_PORi F <br />f� <br />Facility Name: ��dSP�S Jusn Yiie_ L-C.f.+y <br />Facility Address: 22,1 <br />Telephone: i99-3lDS <br />Person Fil}�ng <br />Report l'o ,,,1 (Yldas�� <br />I hereby certify under penalty, of perjury that all inventory variations for <br />the above mentioned facility were within the allowable lixiCs for this <br />quarter. (No in Column 13 of the Inventory Reconciliation Sheet) <br />2 ---inventory variations exceeded the allowable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />was not due to an unauthorized (leak) release. (Yes in Column 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank 1, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank f Amount V <br />r '�I. 1.40 <br />z- 9 19-44 I r 2 122.0-0�® <br />3. E`nv MYON % 2 Z ) <br />4. PERM Mf i' f8 C Ty <br />Additional dates/amounts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which.exceeded allowable limits was due to <br />a leak the incident shall be reported to S.J .L.H.D. Environmental Health <br />within 24 hours and an unauthorized release report submitted. <br />The Quarterly summary report shall be submitted within 15 days of the end of each <br />quarter_ <br />Quarter I - January --) March <br />Qiarter 2 - April --> June <br />Quarter 3 - July --> September <br />Quarter 4 - October --) December <br />Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Ha-r.eIL01), P.O. BOX 2009 <br />Stockton, CA 05201 466-6781 <br />U(;T 40 10/86 <br />