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L nI <br /> INVENTORY. RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: [ting Island Resort Tank Af size Product <br /> Re lar n racnl;no <br /> Facility Address: 11530 w_ Fight Mile Rd <br /> Stockton CA 9S919 <br /> Telephone: (209) 951-2188 <br /> Person Filing <br /> Report: Yvonne Mabee <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. (LIQ in column 13 of the <br /> Inventory Reconciliation Sheet. ) <br /> [' 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 1, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank I Amount Reason <br /> Dipstick misread <br /> 1. 7/27-7/29/91 Regular -41 F accounted fnr 7/31 <br /> Dipstick misread <br /> 2, 8/4 &8/5/91 Regular -87 .45 (Lug_1 arrn>>nt,-d f..,- 2/6 <br /> Dipstick misread <br /> 3 , 8/7-8/10/91 Regular -7S � (Avg 1 arrn„n+ci f 2/11 <br /> Dipstick misread <br /> 4 . 8/16-8/18/91. R[(lnl.or 7 rr arrnnn+crl f" 2/19 <br /> Meter reading impr- <br /> 5.R/?n_g/A 9l pular -116.74 operlv.Acct_ for9/5 <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 - A ri 1 ----------->June <br /> (Quarter 3 ------------> ep em er� OCT 11 tnn� <br /> Quarter 4 - Oc o er ---------> ecem� <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES i.NVIRON ENTAL HEALTH <br /> ENVIRONMENTAL HEALTH DIVISION PER WPSERVICES <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />