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N K�µG 4 <br /> �. RECEIVED <br /> CON��SRV� <br /> OCT 0 2 1992 <br /> R�CI�E� INVENTORY RECONCILIATION ENVIRONMENTAL HEALTH <br /> QUARTERLY SUMMARY REPORT FORM PERMIT/SERVICES <br /> G <br /> �s""`�r CONTI TRUCKING INC. Tank <br /> �QN Ram: Size Product <br /> lscility Address, 2660 LOOMIS RD STKN 95205 1 100 <br /> 2 <br /> Te Zephon,.er: 209 948-59 <br /> Person icing} <br /> Report � r� <br /> I hereby certify under Penalty o4 perjury that ail inventory variations for <br /> the above mentioned facility were within the allowable Limits for this <br /> quarter. (No in Column 13 of the loveatory Reconciliation Sheet) <br /> QInventory variatioas exceeded the allowable limits for this quarter. i <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due to an unauthorised (leak) release. (Yes in Coluaa Q of the <br /> Inventory Reconciliation Sheet) `— <br /> List date. tank 11, and amount for all variations that exceeded the <br /> allowable lismits. <br /> Date Tank f Amount <br /> 2. <br /> 3. <br /> 4. <br /> 5. _. <br /> Additional dates/a,sounts shall be continued on a separate sheet of <br /> paper and attached. <br /> if the source of the variation which exceeded allowable Limits was due to <br /> a leak the incident shall be reported to <br /> 'Within 24 hours aad an unauthorized release report D bmEttedQ�ntal Health <br /> quarterly summary report shall be submitted within 15 days of the end of each <br /> quarter. <br /> Quarter 1 - January --> March <br /> glarter 2 - April <br /> rCec <br /> July --> jcptcmhi:r <br /> October --? 13�ci-mber <br /> Send to: SAN JOAQUIN LOCAL HEALTH Uis*1'1{ 101' <br /> 1601 F . Flar_c• I t iin . 111 .0 . 11()X 2(){)o <br /> tae;1' 40 10/ 86 SLockCan . CA 95201 466-6761 <br />