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... (�A; <br /> INVENTORY RECONCILIATION <br /> QUARTERLY S T FORH <br /> QUARTER ENDING 12-31-87 F <br /> Facility Name: _ TER SI TRUCKING. INC. Tank Size Product <br /> 1 21.980 DIESEL <br /> Facility Address: 90015 VICTOR ROAD 2 5,000 GASOLINE <br /> LODI, CA. 3 1,000 WASTE OIL <br /> Telephone : 209-168-2472 <br /> Person Filing <br /> Report JIM HAIRRELL <br /> © I hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Columna 13of the Inventory Reconciliation Shcet; <br /> E] Inventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due to an unauthorized (leak) releise. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank f, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank f Amount <br /> 1. <br /> 2- <br /> 3- <br /> 4. <br /> .3.4. <br /> 5. <br /> Additional dates(amoun[s shall be continued on a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. exceeded allowable limits was due to <br /> a leak the incident shall be reported to S .J . L. H . D . Environmental Hcalth <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submitted within 15 days of the end of each <br /> quartcr. <br /> Quarter I - January --> March <br /> Quartcr 2 - April --> June <br /> Quarter 3 July --) septcmbcr <br /> Quarter 4 - October --) December <br /> Send co: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E . Hazellon . P . 0 . liox 2009 <br /> Stockton . CA 95201 466 - 67bl <br /> U(;l' 40 10/ 86 <br />