Laserfiche WebLink
INVENTORY RECONCILIATION' <br /> QUARTERLY SUNNARY REPORT FORM 1AAy 1 1989 <br /> facilityName: rA // <br /> // STG'��1 Gk�u Py.T/ Tank 1 1. roduct <br /> Naeilaty Address: J09 ea, <br /> Telephone : <br /> Person Filing j <br /> Report <br /> I;T—[ hereby certify ander penalty of perjury that all inventory variations for <br /> 1 the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Column Ilof the Inventory Reconciliation Sheet) <br /> ❑ Loventory variations exceeded the allowable Limits for this quarter. I 'I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due to as unauthorised (leak) release. (Yes in Columns 13 of the <br /> Inventory Reconciliation Sheet) <br /> List dater tank /r and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank / Amount <br /> I. <br /> 4. 1 <br /> 5. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> Paper and attached. <br /> If the source of the variation which. excceded allowable limits was due to <br /> a leak the incident shall be reported to S.J .L.-H . D. Environmental health <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly susnarY report shall be submitted within <br /> quarter. IS days Of the and of each <br /> (/ atter 1 - January <br /> Qvartcr 2 - Apri�'Y <br /> Quarter ] - July --) September <br /> rartcr 4 <br /> Q' - October --) lkcombcr <br /> Send to: SAN JOAQUIN LQCAI. HEA1.11i UISTNIC-1' <br /> 1601 E. Ilazollnn . P .U . Rnx 2009 <br /> T 4U l0/N4 Stockton . CA 95201 406-67bl <br /> u: . <br />