Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
SAN Jn$QUIN COUNTY PUBLIC HEALTH SERVICES <br /> �, V RONMENTAL HEALTH DIVIS,,.O1 <br /> ANNUAL INVENTORY RECONCILIATION SUMMARY REPORT <br /> California UST Regulations, Article 4, Section 2646 (j) <br /> Facility Name .Sburk> ��,� TV��on q� 14-4/cc- <br /> Address <br /> 'UE'LAddress /3o S' 4!FSC4z0 ) oq-vi City eSc ILO.-1 <br /> All inventory variations for the above mentioned facility were <br /> LZ within allowable limits of Title 23 , California Code of Regulations, <br /> Division 3 , Chapter 16, Section 2646, for the 12 month period from <br /> 799 AI 19-4,� to ?�L�. L_ 19 . <br /> ❑ Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE T. NK # / PRCOUCT I ;LMOUNT (Gallons) <br /> I <br /> I I <br /> I <br /> I <br /> I <br /> I I <br /> I <br /> I <br /> I I I <br /> I <br /> I I i I <br /> Submit remort within 13 days following the end of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JOAENVZRONM NTAYLPHEALTHHDDIVISIONRVICRECEIVED <br /> P.O. Bos 388 APR 3 0 1996 <br /> STOCKTON, CA 95201-0388 <br /> &NVIRONMENTAL HEALTH <br /> I certify under penalty of perjury, that all variations ( i@ERMg/3ERVICE$ <br /> exceeding allowable limits are indicated above (California Health & <br /> Safety Code, Section 25299) : { <br /> , <br /> Facility Tank Oper for/Owner D <br /> EH 23 019 8-1-92 <br />