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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Nage: Moron Paint :ompanv Tank i Size Product <br /> cs o On If ded G <br /> faeiliCy;Address: 3S W. Sonora Street — GC CTri5 <br /> S'_ocktor. , CF. 95203 <br /> Telephone : ( 209 )466-4541 <br /> Person FiLn <br /> Report �t>� �, <br /> I hereby certify under penalty of perjury that all inventory variations for <br /> the above saentiooed foc -lit; "ere within the allc,�Able limits for this <br /> quarter. (No in Colum I3 of the Inventory Reconciliation Sheet) <br /> 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 23 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank f, and nonan[ for all variations that exeeed � <br /> allowable limits- <br /> Date rank Amount JAN 14 1992 <br /> t- /- 7 -9a „Z d E.NVIRONMENTALHEALTH <br /> PERMIT(5E.RYICES <br /> 3_ <br /> 4. <br /> 5. <br /> AdditiaRsl date-!-�+_ocs s!:mI1 �e coaziaued oa a separate sheet of <br /> paper and attached. <br /> If the source Of the variation whichexceeded allowable limits was due to <br /> a leak the incident shall be reported to S J L E.D. Environmental Health <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be xubmitted within 15 days of Che end of each <br /> quarter. <br /> Quarter I - January --) March <br /> Quarter 2 - April --> June <br /> Quarter 3 - July --) September <br /> Quarter 4 - October --) ('iecember <br /> Send to: SAN JOAQUIN LOLAL HEALTii UISTh1CT <br /> 1601 Ha::c I i tin 11 . 0 . lio>: 2(lO9 <br /> SLockCOn , 95201 466 -67bi <br />