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Et <br /> INVENTORY RECONCILIATION Oct 15 19,91 <br /> QUARTERLY SUMMARY REPORT FORM CNVIRONMENTALHALTH <br /> FERMI I • f r?viC;tS <br /> Facility Name: Morton Paint Company tank f Size Produce <br /> Taeilit4,ddress: 3S W. Sonora Street GeG r` <br /> ©OG Crc 5 <br /> Stockton . CA 95203 <br /> Telephone : ( 209 )466-4541 <br /> Repsonort F10- &hn j <br /> I hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for tris <br /> quarter. (No in Column 13 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 /> vas not due to an unauthorized (leak) release. (Yes in Column 13 of the <br /> Lnventory Reconciliation Sheet) <br /> List date, tank i, and amount for all variations that exceeded the <br /> allowable limics_ <br /> Date Tank f Amount <br /> 1. <br /> 4_ <br /> 5. <br /> Eo-ad�tao^zl =atca!- =;;cts cha:l Se continued on a separate sheet of <br /> Paper and accached. <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 .H . D . Environmental 9calth <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submitted within 15 days of [he end of each <br /> quarter_ <br /> Quarter I - January --> parch <br /> Quarter 2 - ApriL --) June <br /> Quarter ) - July __) Septemher <br /> Quarto 4 - October --) licccmbcr <br /> Send to: SAN JOAQUIN LOCAL HEALi'ii DISTRICT <br /> 160 : E . :dare 1 i u P . O lion 2009 <br /> S: o,^^loon . (:! 1!5201 460 -67b1 <br />