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INVENTORY. RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: King Island Resort Tank Size Product <br /> Reaular 6 000 Rea, Gasoline <br /> Facility Address: 11530 W . Eight Mile Rd. <br /> Stockton. CA 95219 <br /> Telephone: (209) 951-2188 <br /> Person Filing <br /> Report: `'vnnne MahPP Manaaer <br /> I hereby certify under penalty of perjury that all inventory <br /> variations for the above mentioned facility were within the <br /> allowable limits for this quarter. (F2 in column 13 of the <br /> Inventory Reconciliation Sheet. ) <br /> CN Inventory variations exceeded the allowable limits for this <br /> quarter. I hereby certify under penalty of perjury that the <br /> source for the variation was not due to authorized (leak) <br /> release. (Yes in Column 13 of the Inventory Reconciliation <br /> Sheet) . <br /> List date, tank ,f, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> L� * Tank I Amount Reason <br /> Dipstick misread <br /> 1. 7/1 -7/2/91 Regular -58.9 (Lj ) accounted for 7/3/91 <br /> Gas expansion due to <br /> 2 . 7/10/91 Reaul ar ±74.2 t Drat,, <br /> Gas expansion due to <br /> 3, 7/12 & 7/13/91 Regular +58.85 (Avg. ) tem»erature- <br /> Gas expansion due to <br /> 4 , 7/1.6 &7/17/91 Regular +72 .9 (Avg.) temoerature_ <br /> Dipstick misread <br /> 5, 7/22/91 Regular -1.08 .4 accounted for 7/24/9] <br /> Additional dates/amounts shall be continued on a separate <br /> sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April ----------->Junes< T <br /> Quarter 3 - July ------------>September <br /> Quarter 4 - October --------->December h L' , <br /> Send to: SAN JOAQUIN' PUBLIC HEALTH SERVICES OCT 1t 1491 <br /> ENVIRONMENTAL HEALTH DIVISION ENVIRONMENTAL HEALTH <br /> " 1601 E. Hazelton Ave. , P.O. Box 2009 PERMIT/SERVICES <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />