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EKED <br /> INVENTORY RECONCILIATION jUL 5 1991 - <br /> QUARTERLY SUMMARY REPORT FORM <br /> King island Resort PNVIRONMENTAL HEALTH <br /> Facility Name: g Tank Rldict <br /> Re lar 6 .0 Reg- Gasoline <br /> Facility Address: 11530 W. Eight Mile Rd. <br /> Stockton. CA 95219 <br /> Telephone: (209) 951-2188 <br /> Person Filing <br /> Report: <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. (No 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 f, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank I Amount Reason <br /> Dipstick misread <br /> 1, 04/20/91 Regular -79.6 accounted for 4/21/91 <br /> Gas expansion due <br /> 2. 04/24/91 Regular +52.5 to temperature. <br /> Misreading on 5/1 <br /> 3,05/05-05/31/91 Regular +430 .98 (AVG.) beginningq dipstick. <br /> accounted for b/1/91 <br /> 4. 06/02/91 Regular -106 .1 Misread dipstick <br /> accounted for 6/3/91 <br /> 5. 06/10/91 Regular +61-8 Gas expansion due <br /> to temperature. <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 /> i_Quarter 2 -_ April_ ----------->June - 11 <br /> Quarter 3 - July ------------>September <br /> Quarter 4 - October --------->December <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />