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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> MESHEARS CHEVRON #3-3823 <br /> Facility Name: PHON1 : ti23-5717 Tank I Saxe <br /> 8 Produ C <br /> VENUE <br /> Facility AddjWWECA> CALINORN//IA 95:3:3F r <br /> Telephone : Z 3 -�71 �7` <br /> Person Filing) <br /> Reportw�(. P:�Zw/1 <br /> hereby certify under penalty of perjury that all inventory variations for <br /> the above mcntiotsed facility were within the allowable limits for this <br /> quarter. (No is column 13nf the Loveatety vL,.e•,,.at1C_o S4eeC) <br /> InvcaCory 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 uaauthoriced (leak) release. (Yee in column IJ of the <br /> loventory Reconciliation Sheet) I <br /> Last date, Caok f„ and a.ount for all variations Chat exceeded the <br /> attowable Basica. <br /> Date Tank / Amount <br /> 1. <br /> J. - <br /> r <br /> 4, <br /> S. <br /> Additiocal dates/a uct,s shall be roncia•te c_ s cepsrate ahcec of <br /> Paper and aCtachcd. <br /> If Chc sOUCCC of Che varsat to, vh.ch exceeded allowable Icmr Cs vas due to <br /> . Icak (ho: inCidenc shall be reported to S .J . I. . Ii . D . Environmental Ilcal ( h <br /> within 24 hours and an unauthor, ccd relcasc rcporc sub.iCEed. <br /> STc ""terlr ■usaaa ry report shall be submitted vichin 15 days of the end of each <br /> qu.rtrr , <br /> Quarter I - Janu.ry -_) H.rrch <br /> Q•iar(Cr 2 - April --> June <br /> Quarter ) - July --> Se Ptemhvr <br /> Q"artc 4 - Octobcr --> lkcembcr <br /> Send co: SAN JOAQUlty I.f)CAl. UtAIJK DIS1'HICT <br /> 1601 E . 1!a7.vIi so , 11 .0 . Hox mr) <br /> /10 IO/ H6 Stockton , CA 95201 466- 67h1 <br /> I11:1' <br />