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-OUTH COUNTY FOOD&FUEL CO. <br /> MD SANDS CORPORATION <br /> POST OFFICE BOX 516 <br /> ESCALON,CA 95320 INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> FaeiLitr Napes <br /> S C r T FTAInkI Size. Proauct <br /> Telephone: 3 — <br /> Person Filin N� <br /> Report T T <br /> �I hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> Quarter. (No in Colume 13of the Inventory Reconciliation Sheet) <br /> Inventocy variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of Krjury that the source for the variation <br /> was not due to An unauthorized (leak) releise. (yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date. tank f, and amount for all variations that exceeded the <br /> allowable limits. RECEIVED <br /> Date Tack / Amount <br /> 1. .IAN 0 9 1992 ; <br /> ENVIRONMENTAL HEALTH 1 <br /> 2. PERMIT; ERV1GFS <br /> 3. <br /> 4. <br /> S. <br /> Add itioeal daces/amounts shall be continued oe a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. exceeded aClowable limits was dun to <br /> a leak the incident shall be reported to <br /> S.J .L.H.D. EovironmentaL Hcalth <br /> Within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submit-ted within 15 days of the end of each <br /> quarter. <br /> Quarter 1 - January --> March <br /> QVarter 2 - April --> Jane <br /> Quarter ) - July --> Scptcmbcc <br /> Quarter 4 - October --> December <br /> Send co: SAN JOAQUIN LOCAL HEALTH DISTRlC1' <br /> 1601 E . 1lazelLon , P .O . Bo:( 200) <br /> SLockcon . CA 95201 466-67bl <br /> UCT 40 I0/86 <br />