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0 <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY RFPORT FORM <br />Faeilit Name: JOHN TAYLOR FERTILIZERS <br />1 nF crnf-KTr) l <br />P. O. BOX 6098 <br />facility •Address: STOCKTnN C ALIF_95206 <br />Telephone: <br />Person Fil <br />Report <br />rw r; <br />ElEIVE . <br />OZY'Peniggg <br />'.1NMENTAL HEALTH <br />i'E: Z:JIT/SERVICES <br />N <br />® 1 hereby certify under penalty of perjury that all inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />Quarter. (No in Colu® 13 of the Inventory 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 an uaauthorixed (leak) release. (Yes in Colus- IJ of the <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank ! Amount <br />4. <br />5. <br />Additioaal daces/amounts shall be continued on a separate sheet of <br />paper and arzach,d- <br />If the source of (tie variation which exceeded allowable limits ,as due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental 11calch <br />within 26 hogs and an unauthorized release report submitted. <br />The Quarterly s-ummary report shall be submitted within 15 days of the end of each <br />Quarter. <br />Quarter I - January --% March <br />April --> Jane <br />QuartQuarter ) July --> Scptcmhrr <br />er <br />r 4 - Octobcr --> 0kcembcr <br />Send co: SAN JOAQUIN LOCAL HEALI'li DISTHICT <br />1001 E. Hazp114m, P.O. Itnx 2.009 <br />Stockton. CA 115201 460-67b1 <br />UGT 40 f0/H0 <br />