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SAN JOP "IN COUNTY PUBLIC HEALTH SF-7ICES <br /> I IRONMENTAL HEALTH DIVISION <br /> ! ANNUAL INVENTORY RECONCILIATION SUMMARY REPORT �_I'f1 <br /> California UST Regulations, Article 4, Section 2646 (j) <br /> krk : 22 <br /> Facility Name t .A-M ?K"w �i �n��I)' /%I <br /> Address Cc/00 N- Y�IC,�w/�; `�' j City cK��� 95 VZ_- <br /> aAll inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Regulations, <br /> Division 3 , Chapter 16, Section 2646, for the 12 month period from <br /> 19 to 19 <br /> aInventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK / PRODUCT AMOUNT (Gallons) <br /> gy / miA - a,�� Ovf-r- b S <br /> och&Al 1,3 rt l Ivy.10 - Gn4-D E 0 d.ti b j / 5 d <br /> Oc o L.v 199 3 Sugoej, Gt i-e Lded Out-- to <br /> Nbvfa.h.v r9 3 zt7 I G DEQ✓ /-F <br /> Lbw rvt��- G2ADz 0ux•- b Pe <br /> e�bti✓ 17- w.4.1 tsCoverc cl w� /12«l-brad <br /> u.•• o- f c1,4 d /4 o-r 4-L c, Co rrc / — a 6e 1,eue_ ,a <br /> 7"t,,,l w A., Tk,- c d ere. Le- <br /> Submit report within 15 days following the end of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> I certify under penalty of perjury, that all variations (if any) <br /> exceeding allowable limits are indicated above (California Health & <br /> Safety Code, Section 25299) : <br /> Facility Tank Operator/Owner Date <br /> EH 23 019 8-1-92 <br />