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Jv`�f INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: San Joaquin Lumber Co. Tank i Size Product <br /> 1 1000 Gas <br /> Facility Address: 235 W. Scotts Ave 2 5000 iese <br /> Stockton Ca. - - <br /> Telephone : 465-5 51 <br /> Person Filing <br /> Report Wm. Schneider <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 Column 13 of the Inventory Reconciliation Sheet) <br /> E] Inventory variations 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 unauthorized (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank 1, and amount for 21L variations that exceeded the <br /> allowable limits. <br /> Date Tank R Amount <br /> 1. Fggavzo <br /> 2.3. CT 1988 � <br /> 4. <br /> ENVIRONMU-4*AL HEALTH <br /> 5. PERMIT/SERVICES <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. esceeded allowable limits was due to <br /> a leak the incident shall be reported to S .J .L.H . D . Environmental Ilea lth <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submitted within 15 days of the end of each <br /> quarter. <br /> Quarter I - January --) March <br /> Qna.eec.L_2 - April --) June <br /> July --) September <br /> Quarter 4 - October --) December <br /> Send to: SAN JOAQUIN LOCAL HRALTli DIS'T'RICT <br /> 1601 E . Hazelton . P .O . Ros 2009 <br /> Stockton . CA 95201 466-6781 <br /> UC;I' 40 10/ 86 <br />