Laserfiche WebLink
INVENTORY RECONCILIATION a-to, QUARTER ENDING 12-31-91 <br /> QUARTERLY SUMMARY REPORT FORM OCT, NOVO DEC <br /> Facility Name: TERESI TRUCKING INC Tank # Size Product <br /> 1 1 21,980 DIESEL <br /> Facility Address : 900 VICTOR ROAD 2 50000 GASOLINE <br /> LODI, CA 95240 3 1,000WASTE OIL <br /> Telephone: 209 368-2472 <br /> Person Filing <br /> Report: JIM HAIRRELL <br /> I hereby certify under penalty of perjury that .a31 inventory variations <br /> a for the above mentioned facility were within the allowable limits for <br /> this quarter . (No in Column 13 of the Inventory Reconciliation Sheet. ) <br /> Invent.ory variations exceeded the allowable limits for this quarter. I <br /> ❑ hereby certify under penalty of perjury that the source for the varia- <br /> tion was not due to unauthorized ( leak) release. (Yes in Column 13 of, <br /> the Inventory Reconciliation Sheet) . <br /> List date, tank # , and amount for all variations that exceeded <br /> the allowable limits . <br /> Date Tank # Amount <br /> 1 . <br /> 2 . nr 3 . EIVED <br /> 4 . JAN 0 6 1992 <br /> 5 . ENVIRONMENTAL HEALTH <br /> /� V, C <br /> Additional dates/amounts shall be continued on IT� � € sheet <br /> paper and attached. <br /> If the source of the variation which exceeded allowable limits was <br /> due to a leak, the incident shall be reported to San Joaquin Local <br /> Health District; Environmental Health Division, within twenty-four <br /> ( 24 ) hours and an unauthorized .release report submitted. <br /> The quarterly summary report shall be submitted within fifteen ( 15 ) days <br /> of the end of each quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April------------>June <br /> Quarter 3 duly-------- ->September <br /> Quarter 4 - October---------->December <br /> Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton, P.O. Box 2009 <br /> Stockton, CA 95201 468-3420 <br /> LFI 23 019 10/86 <br />