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OV <br /> INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM 01C T 1 n 19 88 8 <br /> Facility Name: <br /> Tank i Size <br /> Facility;Addre..: �o / product <br /> Tele hone : cg rZo� z � e <br /> p <br /> Person Filing ��/ <br /> Report <br /> dL hereby certify under '- <br /> the above penalty of perjury that all inventory variations for <br /> oenti <br /> quarter. (Ho ioned facility were within the all limits for this <br /> n Column 13 of the Inventory Reconciliation Sheet) <br /> ❑ 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 so unauthorized (leek) release. <br /> Inventory Reconciliation Sheet) (Yes in Coluam 13 of the <br /> List date, tack /, and amount for all variations that exceeded the <br /> Allowable limits_ <br /> Date Tank E <br /> Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> Additional dates/amuocs shall be continued on a separate sheet of <br /> Paper and attached. <br /> tt the source of the variation which exceeded allowable limits was due to <br /> a the <br /> Che incident shall be reported Co <br /> within 24 $ ,J . L.H. D. Environmental Flca(th <br /> hours and an unauthorized release report submitted. <br /> The Quarterly summary report shall be submitted within IS days of the end of each <br /> quarter. <br /> Quarter 1 - JaauarY --) March <br /> Quarter 2 - April --> June <br /> Quarter 1 - - <br /> July September <br /> Quartet 4 - Occober --) <br /> December <br /> Send Co: SAN JOAQUIN LOCAL. HE:ALT]i OIS'1'R1C1' <br /> 1601 E. Ilazc ! ( m , 1, .0. Box 2009 <br /> _ <br /> 40 LO/NG Stockton , CA x/5201 466 -6781 <br /> L <br />