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ANNUAL STATISTIC _ INVENTORY RECONCIL .TION (SIR) REPORT <br /> Annual summary reports are required for retail and non-retail facilities <br /> FACILITY NAME Circle K No. 01205 _ PRODUCT Unleaded Plus <br /> FACILITY ADDRESS 16470 Cambridge TANK I.D. Number 3900001532-1 <br /> CITY,STATEZIP Lathrop, CA 95330 <br /> D// <br /> TANK OWNERIOPERATOR The Circle K Corporation. TANK CAPACITY 9,980 <br /> LAST TANK TEST DATE I I PAS AIL LAST LEAK DETECTOR CHECK DATE ) /9 f ASS/ AIL <br /> LAST PIPING TEST DATE /O� <br /> S AS AIL LAST METER CALIBRATION CHECK DATE PASS/FAIL <br /> All monthly SIR results for the above mentioned tank at the above mentioned facility were"pass"for the twelve <br /> month period from January, 1995 to December, 1995. <br /> ❑ Monthly SIR results showing"fail"or"inconclusive"occurred an the following months, in the listed amounts,for the <br /> UST. If the SIR result for a month exceeded the SIR method's threshold or was inconclusive, appropriate corrective <br /> actions described in Section 2646.1 must be taken.The local agency must be notified within 24 hours of receiving a <br /> 'failed"or"inconclusive"SIR report. <br /> Summary of text results from monthly SIR reports. Complete for all 12 months. <br /> Minimum <br /> Leak Detectable Calculated <br /> Threshold Leak Rate Leak Rate Pass, Fail <br /> Month/Year (gph) (gph) (gph) Inconclusive <br /> 1 7Jan 1995 0.10 0.10 -0.05 Pass" <br /> 2 Feb 1995 0.10 0.10 0.04 Pass <br /> 3 Mar 1995 0.10 0.20 0.02 Pass <br /> 4 Apr 1995 0.10 0.20 0.04 Pass <br /> 5 May 1995 0.10 0.20 -0.03 Pass" <br /> 6 June 1995 0.10 0.07 0.04 Pass <br /> 7 July 1995 0.10 0.05 -0.03 Pass" <br /> 8 Aug 1995 0.10 0.20 0.01 Pass <br /> 9 Sept 1995 0.10 0.20 -0.04 Pass" <br /> 10 Oct 1995 0.10 0.16 0.05 Pass <br /> 11 Nov 1995 0.10 0.20 -0.10 Pass" <br /> 12 Dec 1995 1 0.10 0.20 -0.06 Pass" <br /> No Analysis Performed <br /> Negative Calculated Leak Rate indicates a Gain <br /> Submit report within 15 days following the end of the last month of the twelve-month period covered by this summary report. <br /> Send to: (local implementing agency) <br /> 1 certify under penalty of perjury that all SIR results listed above are as calculated. <br /> JAN 2 5 1538 <br /> SignaturekOwner/Operatoror Agent Data <br /> S W RCB-AnnuWSIR.INV-02 <br />