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SIRAS Input Template <br /> i <br /> Tank ID No JOE-4 Return Completed Form to: <br /> Site Name JOE'S PLACE Shields, Harper & Co./EnviroQuest <br /> Tank size (Gap iz,o0o P. O. Box 3066 <br /> Tank Contents: DIESEL Oakland, CA 94609 <br /> Period Ending <br /> Opening Stlok Time of Gallons Pumped Deliveries Time of <br /> Day of Day of Reading In Water Stick (Sales) (Net Gallons) Delivery <br /> Montth Week Gallons Level Reading From Your <br /> Meter Readings <br /> 2 / <br /> tis. `�, 37 / 7 7-/c' 0 <br /> 9(; IE E d- O 7 p,rf10 <br /> 6 /"• .wi g ' <br /> 12 a Irk S �`0 j -- -- - - <br /> l <br /> 13 j�sl r'-�/>' ��� �,'✓f' �,' `-,a !� O l ) ��',-�` /kJ; �'•'`•,t,j%.-, <br /> 14 <br /> 16 -i '.c i dopy/ <br /> 17 ' ' .r7.r.:, -3 00 • 7S^ 7o <br /> 1 U amu' Z/// — <br /> 20 <br /> 21 /, ?/ car 7 I—Z/ o 0 l �✓ <br /> 24022 loo <br /> 0 3/ C �97 <br /> 25 // Pf f,' 7r0 ,3t/6 <br /> 26 //Q11�l�' o t . �- <br /> 27 Ila?-9 `/0 <br /> 26 11-2f 19f" R 73 ��` cf rro I 7T3/ a <br /> 2s // g ,� 2 / �jJr <br /> 30 I/-7� y!` 71' X11/ D` c� G'i` S r 7 / o <br /> 31 <br /> 8 7;7- <br /> Posing Reading (Obtain at the end of the day or use <br /> NEXT DAY opening reading) <br />