Laserfiche WebLink
rq l <br /> QUARTEA.Y INVENTORAE' PORTING <br /> Facility Name: E', 1 ' 'y ('(—OLA) J h-2 I Tank # Size Product <br /> 0-O 0 <br /> Facility Address: yy)l}"I N S 00 <br /> City: �� -) <br /> County: <br /> T <br /> State: <br /> 1W <br /> Waste Oil <br /> rNV'iROiNNIE(,iTAL 1-1 FA r. <br /> These were inventory variations thR VIIJ/c Liiy �hereby certify that all product level variations <br /> ❑/ exceeded the allowable limits for this' '❑� for the above mentioned facility were <br /> quarter. within allowable limits for this quarter. <br /> LIST DATE, TANK# AND AMOUNT FOR ALL VARIATIONS OUT OF TOLERANCE <br /> THAT EXCEED THE ALLOWABLE LIMITS. INVESTIGATIVE STEPS <br /> Step 1 Review Records . <br /> Date Tank# Amount Explanation Step 2 New reconciliation <br /> -xo S.rP� oC ✓A A-5 / �9 performed. <br /> Step 3 Shell Oil notified. <br /> Step 4 Records review from <br /> J, ✓ the last stable <br /> situation. <br /> Step 5 Physical facilities <br /> }3 TorK inspected for leaks. <br /> o2'II (2 U _ / s (� o Step 6 Dispenser meters <br /> calibrated. <br /> ' —r-t 5 Step 7 Piping hydrostatically <br /> 13 _ 3 �� tested. <br /> Step 8 Underground storage <br /> a 13,14 t?--j /o,a) tanks precision tested. <br /> 3413 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 thru March <br /> Submit by April 15 <br /> ❑ Quarter 2 — April thru June <br /> Submit by July 15 <br /> ❑ Quarter 3 — July thru September <br /> Submit by October 15 <br /> ❑ Quarter 4— October thru December <br /> Submit by January 15 <br /> Send to (Local Agency): �-� , <br /> ke,049- I 0,0�l 1 � sT <br /> oc �. 7 o.-). C.a. . 0 c <br /> COPIES PF THIS FORM FOR YOUR RECORDS <br /> ,14& 41-) -1 1 <br /> DEALER SIGNIXTURE DATE <br />