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SAN JOAQUIN COUNTY PUBLIC HEALTH S*ICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ANNUAL INVENTORY RECONCILIATION SUMMARY REPORT <br /> California UST Regulations, Article 4 , Section 2646 (j ) <br /> Facility Name 2L-7gLz�� <br /> Address -2city � tj <br /> All inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Regulations, <br /> Divi ' on 3 , Chapter 16, Section 2646, for the 12 month period from <br /> �t 19 '1 to 19 ` . <br /> Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK ,# j PRODUCT AMOUNT (Gallons) <br /> r <br /> Submit report within 15 days following the end of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> I certify under penalty of perjury, that all variations (if any) <br /> excep,ding allowable limits are indicated above (California Health & <br /> 4, - <br /> e . ection 299) : <br /> ant Operator/Owner Date <br /> f, <br /> EH 23 019 8-1-92 <br />