Laserfiche WebLink
V� <br /> INVENTORY RECONCILIATION ��. <br /> QUARTERLY SUMMARY REPORT FORK <br /> Facility Hame: "t tic` y�yU , Tank <br /> Facility Address: L11c,4a ft <br /> Telephone : g <br /> Person Filing <br /> Report <br /> L hereby certify under peealty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Column L3 of the loventory Reconciliation Sheet) <br /> Inventor variations exceeded the allowable limits for this <br /> Inventory quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due to an unauthorised (leak) rele-ase. (Yes in Column 13 of the <br /> Levectory Reconciliation Sheet) <br /> List date, tack I, acd amount for all variations that exceeded the <br /> allowable limits_ <br /> Date Tank 0 Amount <br /> I . <br /> 2. <br /> 3. �(f <br /> 4_ <br /> 5. <br /> AdditiooaL dates/amounts chall be continued ou s separzte sheet of <br /> paper 2nd attached. <br /> LE the source of the variation which exceeded allowable limits was due to <br /> a leak the incident shall be reported co S .J . L . .L . H . D . EnviranmentaL Health <br /> wkrhtn 34 hours and an unauchorixed release report submitted. <br /> the quarterly summary retort shall be rtibmitted within 15 days of the end of each <br /> quarCrc <br /> Q�actcr I - January --) H,lrct% <br /> Qeiarter 2 - Apri L --> Juni, <br /> Quarter ) - July --> Scpcefnhi-r <br /> Quarter 4 - October --) i)rcc•mher <br /> send ca. SAN JOAQUIN 1.0CA1. HEAL1'I; DISTKIC:T <br /> 160L f•. . Hzic• It4w , P .0 licix 2009 <br /> SLockLon , CA 95101 1,60 -6lb1 <br /> Uc:1' 1-0 10/ 86 <br />