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INVENTORY. RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM 7 02 <br /> { <br /> Facility Name: King Tsland Rpsnrt Tank sit P <br /> Reqular W I"k <br /> Facility Address: 11510 W Finht MiIP Rr9 <br /> .Stncktnn !'A 9591 Q <br /> Telephone: (209) 951-2im <br /> Person Filing <br /> Report: Wendy Hoffman <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 /> �7 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 Amount Reason <br /> Temp Change <br /> 1. 10/9/92 Reaula_r 75.7 Fxoansi_nn <br /> Temp Change <br /> 2. 10/23/92 Regular 57.7 Rxnpansinn <br /> 3 . <br /> 4 . <br /> 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 - April ----------->June <br /> Quarter 3 - er J - ---- - >September <br /> Quarter 4 - Octob ->December <br /> - 2epoc-i- <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 />