Laserfiche WebLink
.r <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Faculty Names 5 Tank i StzeProduct <br />usr/ e <br />F.eiliey Addre.ai <br />eo <br />Telephone: q 5 <br />Person Filing/��/ <br />Report ,S�l/eW9A! <br />❑ i hereby certify under penalty of perjury chat all inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />quarter. (No in Colum 13 of the Loventory Reconciliation Sheet) <br />❑ 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 as unauthorized (leak) release. (Yes in Colon 13 of the <br />Inventory Reconciliation Sheet) <br />List dater tank is and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank ! Amount PV <br />_- /ft <br />3. /o e 3 OCt 6 1988 <br />4. <br />PEr"W t SERVICES <br />5. <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 at lovable 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 1 - January --) March <br />Quarter 1 - April --> June <br />Quarter 3 - July --) September <br />Q%.artcr 4 - October --) lkccmhcr <br />Send co: SAN JOAQUIN LOCA1. HEALl'li D1S'1'H1C1- <br />1601 E. Hazelloll. I'.O. Hoe 21107 <br />Stockton, CA 95101 466-61bl <br />!)CT 4O 10/86 <br />