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Ivy <br /> INYENfORY RECOflCIL W <br /> Ion APR 1 71989 <br /> TENVReryEyTgl HEALTH <br /> QUARTERLY SUMMARY REPORT FORK <br /> Facility NaaK; SCa S PIERMIOWT/SERVICES <br /> facility Address: <br /> y� Tank / Size P <br /> da <br /> '[duce <br /> --��_ y Q y <br /> Telephone : � r�� s G��i '- io v .1 L <br /> PersonFijiE � <br /> Report: • P o t e <br /> L hereby certify <br /> the above • under facility <br /> y of perjury that •ll inventory variations <br /> �ent(oned facility vete vithin the •,,[wile licit•variation, <br /> quarter. (f(o io Colu® U for <br /> of the lsveucory Reconciliation Sheet) <br /> this <br /> ee,.T <br /> QInventory vaciacioos <br /> hereby cectif exceeded the allowable licit• for Chi• <br /> QOCY under penalty of Perjury that the source for quarter. I <br /> unauthW44 nto due to as iAtion Sheet ((esk) cele�se. (Yes <br /> Inventory the variation ' <br /> Y Reconciliation Sheet) 1° Onl�+ t] of the <br /> I <br /> l.liat dace, talk /, and aoounc for all variations <br /> •(lovable lieiCs_ <br /> that ecceeded the <br /> i <br /> oat, Talk / <br /> 1. - Amount <br /> 4• <br /> -- <br /> S. <br /> AddiCio[al daces/ <br /> amou continued <br /> Paper and actac hed, ots shall be oa • ae • <br /> P rate •heec of <br /> !f Che source of Che variation ..h ich c'tc'eded allowable <br /> l <br /> a leak Che int(Ce nt shall be r' >r <br /> luw ble B'a'ta vas due Co <br /> 4(Chtn 14 hours and a Pr (ed to <br /> n unauCJwrt 5 . .1 . I- . H . b , F.nvtronmcnCal Ilcalth <br /> <Ttc QuarCerl ted "'lease report submiCCed. <br /> Quart.." Y su•.y ry rgpurC shall b <br /> submtCted within 15 days of Che end of etch <br /> (�u r l t I <br /> Lunary <br /> Q•uttrr --) f1.trCh <br /> tltrar('r 1 JI, y ) Jn.... <br /> ..1 ) 1c tt <br /> Q11a"ter C I ember <br /> - October __) 11.•c'mb'r <br /> ;end Co: <br /> "11 JQA(1l1 (ry 1.1)(.Al. HEAI.7li I)I ;i'1'I< IC'I <br /> t• I I tin . 1' . 0 . Hn•r 2009 <br /> 101n6 -Stockton , CA 1/5201 460 -6181 f <br />