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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Haa.e: Stockton Center Tank It Size Produce <br /> =00--g--a-f-.U-71ea e <br /> Facility Address: 1804 W. Main Street <br /> Stockton, CA <br /> Telephone : (415) 465-3700 <br /> Person Filing <br /> Report Walter J. Bishop <br /> ElI hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Column 73of the Inventory Reconciliation Sheet) <br /> ElInventory variatioas 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 as unauthorized (leak) releise. (Yes in Colo— 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank i, and amaount for all variations that exceeded the <br /> Allowable limits_ <br /> Date Tank / Amount <br /> 1. <br /> 1. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amoouats shall be continued on a separate sheet of <br /> paper and accached_ <br /> If the source of the variation whichexceeded allovable limits was due to <br /> a leak the incident shall be reported to S .J . L. H . D . Enviconmencal Healch <br /> within 24 hours and an unauthorized release report submicted_ <br /> The Quarterly summary reporc shall be Fubmitced vichin 15 days of the end of cacti <br /> quarccr_ <br /> Quarter 1 - January --) March <br /> Q,iartcr 2 - April --> Junc <br /> Quarter 3 - July --) Scpccmhcr <br /> Quarter 4 - October --) llecember <br /> Send co: SAN JOAQUIN LOCAL HEALTH DISFRICT <br /> 1601 is _ Haze I 1 ,�n • P . 0 Box 2009 <br /> stockr.on , CA 95201 466 -6Ibl <br /> ucr 40 loib�, <br />