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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> laduty Name: j1L)t4,s�9I E tc M&T Task <br /> Stce Product <br /> lacLlitr lldAraaas Wo to ya S ti�u, Tt <br /> M�N'}7'EC�4 <br /> Telephone: L,Z C,c�/ br23 -loo � . <br /> Person Miff <br /> Repo Repot — /�f�i�yP /� `� LJ d <br /> I hereby Certify under penalty of <br /> Che above mentioned facility were vithinytherjaallowableentoLimt all itsvarfaatithisa for <br /> quarter. (No in Column Il of the laveatory Reconciliation Sheet) <br /> ❑ Iovestocy variatioas exceeded the allovable Limits for this quarter. I <br /> hereby certify wader penalty of per jury that the source for the variation <br /> vas not due to so unauthorized (leak) release. (Yes is Coltman Il of the <br /> t laveatory Reconciliation Sheet) r t <br /> List date, tsok /r sad amount for all variations Cha eed thxceed <br /> allowable limits. ✓9�L 7��11J�S GJl t �£S?f 9 'th <br /> �vo PSS <br /> Date Tank It <br /> Amount <br /> 1- — — YLc�y �� /qLL )DIC SF11 <br /> z. <br /> 4. <br /> s. ✓ //VS % «P-� <br /> 7-I►NkJ' <br /> Cr£4 > LLOaIJ 2 <br /> MdlCioosl dates/amount:. shall be continued oo a separate sheet of (, //t'f/ TV, <br /> Paper and attached . <br /> If the source of Che vat ia[ ioo ..h,ch cxcr<ded allow ble liml[s As due to <br /> • Ieak the rnC ,dcn( shall be rcpur(c,l to <br /> w than 24 h r . J Env,ronmcn[al Ilcalth <br /> ours and an unauthor, t<d re loasr repootr(t subm,CC<a1. <br /> 1Te q.Ac(y sum.ury report shall <br /> Vuar(er . b< aubm, ((cd vithtn IS days of the end of each <br /> Quarter I - January __) ryarch <br /> Q•sarccr 2 - April <br /> Quarter ) - J,,Iy --> icpcemh,•r <br /> Qsartcr t. - Oc[obcr --> OcCcmhcr <br /> Send Co: SAN JOAQUIN LOCA1. IItAI.11i DISTRICT <br /> 1601 E. 1!�i(• Il1, .0 RDx %11(19 <br /> 40 10/R6 SLockton , CA 95201 466-67b1 <br /> Ut;1' <br />