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INVENTORY RECONCILIATION J <br /> r: <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: HRESHEARS CHEVRON ,• Tank t Sice <br /> Product <br /> Facility Address: 4 EAST YOS ati#1Tk; AVENUL L MF r � <br /> KEkPd �. )GA 950 _ <br /> C <br /> Telephone : <br /> Person Fiji" <br /> Report -2e,Xc <br /> hereby certify under penalty of perjury that all inventory variations for <br /> the above s»sr:e l facility scre within the allowable limits for this <br /> quarter. (Ho in Column 13of the Inventory Reconciliation Sheet) <br /> QIaventocy variations exceeded the allowable limits for this quarter. 4 <br /> hereby certify under penalty of perjury that the source for the varistioa <br /> was not due to an unauthorised (Ieak) release. (Yes in Colum 13 of the <br /> Inventory Reconciliation Sheet) I <br /> List date, tack 1, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank / Amount <br /> 1. <br /> 2. <br /> 4. <br /> S. <br /> •'.ddit onai dacesfamouotx shall be contioaed on a separate sheet of <br /> Paper and at[ached. <br /> It the source of (he variation which exceeded allo..ahle limits w s due [o <br /> • leak the snctdcnt shall be reported to S .J . I. H . D . Environmental llcaltll <br /> wtchin 24 hours and an unanthornccd release report sobaitted. <br /> "he quarterly u—c y report shall be submitted within IS days of the end of each <br /> Quar[.•r • <br /> Qu as[cr t - Janu.ry __) H.1rch <br /> Qaarter 7 - April --> Juu1: / <br /> Q.artc G - October --) 1>t ccmher <br /> Send (o: SAN JOAQUIN 10(:Al. IIEAI.1'1; DISTRICT <br /> 1601 E . LIa,t• I1 1n • P .O . Box 2nn ) <br /> Stockton . CA 95201 466-6761 <br /> ur.T 40 10/ H6 <br />