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SAN jOA(, U IN COU14TY PUBLIC HEAl�Th SERV iCl':' <br />IRONMENTAL HEALTH DIVIS106 <br />An -UAL INVENTORY RECONCILIATIC'N SUMMARY REPORT <br />California UST Regulations, Article 4, Section 2646(j) <br />Facility Name <br />Address ,l Lc�%5citySC�l�� <br />+- re,] All inventory variations for the above mentioned facility were <br />+ r4 <br />within allowable limits of Title 23, California Code of Regulations, <br />Division 3, Chapter 16, Section 2646, for the 12 month period from <br />19 to 19 <br />j Inventory variations in excess of the allowable limits of Section <br />L�J 2646, occurred as listed below. <br />Submit report within 15 days following the end of the last month of the <br />-2.-izc;nth 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 388 <br />STOCKTON, CA 95201-0388 <br />I certify under penalty of perjury, that all variations (if any) <br />exceeding allowable limits are indicated above (California Health & <br />Safety Code, Sectio 25299) : <br />C-/- <br />7acilLty Tank Operator/Owner Date <br />EH 23 019 8-1-92 <br />