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QUARTERLY INVENTORY kPORTING <br /> W4tnt� <br /> Facility Name: I'� 1 lYl ll1l� <br /> 1 14 <br /> IVlnr. et• -Facility Address: _33City:County:State: l `A S � <br /> These were inventory variations that I hereby certify that all product level variations <br /> exceeded the allowable limits for this ❑ withhe above mentioned facility were <br /> in allowable limits or this quarter. <br /> quarter. <br /> OUT OF TOLERANCE <br /> LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS INVESTIGATIVE STEPS <br /> THAT EXCEED THE ALLOWABLE LIMITS. Step 1 Review Records . <br /> to Tank # Amount Explanation Step 2 pew ciliation <br /> performed. <br /> r Step 3 Shell Oil notified. <br /> Step 4 Records review from <br /> the last stable <br /> situation. <br /> Step 5 Physical facilities <br /> inspected for leaks. <br /> a <br /> s� Step 6 Dispenser meters <br /> spa calibrated. <br /> 2 t '��2 Step 7 Piping hydrostatically <br /> tested. <br /> RONMENTAL IFAL-TW Step s Underground storage <br /> PERMIT/ LICES tanks precision tested. <br /> Step 9 Additional investigation <br /> as required by Shell <br /> or the local agency. <br /> This quarterly summary report <br /> shall be submitted within 15 days <br /> after the end of each quarter. Check <br /> the quarter you are submitting <br /> ❑ Quarter 1 — January <br /> Submit mit March <br /> 115 <br /> '�❑(/Quarter 2 — Aprilthru June <br /> Submit by July 15 <br /> �l)(1 Quarter 3 — July thru September <br /> Submit by October 15 <br /> ❑ Quarter 4— OSubmitctober thru December <br /> by January 15 <br /> Send to (Local Agency): (14 <br /> C EAI <br /> II nl G AZA oAl <br /> K EP COPT S OF THIS FORM FOR YOUR RE OR S <br /> 0 � <br /> LE SIGNATURE <br /> DA E <br />