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: '0 ygggaya <br /> INVENTORY RECONCILIATION JAN 17 1989 <br /> QUARTERLY SUMMARY REPORT FORM ENVIRONrnENTFI HEALTH <br /> PERMIT/SERVICES <br /> Facility N2me: Stockton Center Tank / Site <br /> Product <br /> Facility Address: 1804 W. Main Street 4a unleaded <br /> Stoc ton, <br /> Telephone : (415) 465-3700 <br /> Person Filing <br /> Report Walter J. Bishop <br /> QI hereby certify under penalty of perjury that all inventory variations for <br /> the above eencioned facility Were within the allowable limits for this <br /> quarter. (No in Columa 13of the Inventory Reconciliation Sheet) <br /> ❑ Inventory variations exceeded Che allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due Co an unauthorized (leak) release. (Yes in Coles 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank I, and amount for 211 variations Chat exceeded the <br /> allowable limite- <br /> Date Tank I Amount <br /> 1_ <br /> 2. <br /> 3- <br /> 4. <br /> 5. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> paper and aCtached_ <br /> If the source of the variation vhich. excceded allowable limits was due to <br /> A leak the incident shall be reported to S .J . L. H . D. Environmental Hcalth <br /> Within 24 hours and an unauthorized release report submitted. <br /> The Quarterly summary report shall be submitted within 15 days of the end of each <br /> quarter. <br /> Quarter 1 - January --) March <br /> Qjarcer 2 - April --) Junc <br /> Quarter 3 - July --> septemhcr <br /> Quarter 4 - October --) December <br /> send to: SAN JOAQUIN LOCA1. HEALTh DISTRICT <br /> 1601 is I!.izc 1 t u 1' . 0 . liox 20119 <br /> t'(:1 40 10/H4 Stockt-on . CA 95201 466 - 6781 <br />