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INVENTORY RECONCILIATION F F 8 25 1987 <br /> QUARTERLY SUMMARY REPORT FORM ENVIROMENTAL HEALTH <br /> F ERMIT/SERVICE$ <br /> Facility flame: Morton Paint Company ink Size Product <br /> Facility Address: 38 W. Sonora street 0 <br /> st2ckton - CA 95203 <br /> Telephone : 209 466-4541 <br /> Person F i g <br /> Report L1 <br /> 10/L 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 o€ the Inventory Reconciliation Sheet) <br /> Elinventory 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 /> inventory Reconciliation Sheet) <br /> List date, tank f, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank f Amount <br /> 3. <br /> 4. <br /> 5. - <br /> Additional dates/amouoti 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 /> S .J .L.H . D . Environmental Health <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 1 January --> March <br /> aarCcr - April --} June <br /> Quarter ] - July --> septemher <br /> Quarter 4 - October --> l)cce•mber <br /> Send to: SAN JOAQUIN 1.0CAl, HEALTH H DIS-1-KIC'1' <br /> 160L E: . E:arc l i a�iti , E' .U , lic�x 2()()9 <br /> Stockton . CA 115201 460 -676L <br /> t1c;T 40 10/ 96 <br />