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INVENTORY RECONCILIATION nt l u3 j^, j <br /> QUARTERLY SUMMARY REPORTFORMPORN `` ' I' IA 1 t <br /> 8RESHEARS CHEVRON 7'3-383 P._" <br /> Facility Name: PHONE: 82-"-5717 Tank <br /> Sire Product <br /> Facility Ad&JjWOA� CALIH)RNIA <br /> f <br /> ' � T <br /> Telephone : i7 _- <br /> Person Filingg <br /> ReporCf L[ <br /> 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 Colum 13of the Inventory Reconciliation Sheet) <br /> ❑ lnventccy variations exceeded the allowable limits for this quarter. I <br /> bercby certify under penalty of perjury that the source for the variation <br /> was not due to an uaauthoriced (leak) release. (Yes in Column 13 of the <br /> inventory Reconciliation Sheet) t <br /> List date, tank fp and amount for all variations that exceeded the <br /> allowable liwica. <br /> 4. <br /> I. <br /> 5. <br /> Additional dates/amount., shall be continued on a separate sheet of <br /> Paper and attached. <br /> if the source Of the variation vh.<h c.cecded a[ luvable Itmr t3 vas dc to <br /> e <br /> 'Cal( the incident shall be reported to S .J . I. . II . D . Environmcntat lical(h <br /> with ui 24 hours and an unauchnr.tcd release repoc( sub.itted . <br /> ll.< Quarterly "••nary report shall be submitted viehin 15 days of the end of each <br /> q...r tr r , <br /> Quarter I - January --) n.srcl. <br /> Qaar(cr 7 - April --> J..n.. <br /> Quarter ) - July --) Scptc.h.-r <br /> Q.artr 4 - October --> 1><c.•.hcr <br /> Send to: SAN JOAQUIN 1.0CA1. IiEAI.I•li DISTKiCT <br /> 1601 E . Vazelit,n , V .0 isor %111)') <br /> Stockton . CA 95201 466-67bl <br /> 111:1' 40 10/ N6 • . <br />