Laserfiche WebLink
r <br /> INVENTORY RECONCILIATION -�-`' <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Namc: -( ��l/ %J 'tank I Sisc Product <br /> Facility Addccsa: (,,-2 &6ry <br /> _ y / <br /> Telephone ; , <br /> Person Filin ' <br /> Report <br /> I hcccby cercil3y under pcoalty of perjury that all invcntosy variaciooa for <br /> the above acacioned facility were within chc allowable limits for thio <br /> quarter. (No ill column 13of the lgvcgcory Reconciliation Sheet) <br /> (] taventory variatioas exceeded chc sllvwable limits tqr Cbia quarter. i <br /> bereby certify Uadcr penalty of perjury that the source for the variation <br /> waa Got dye to so unauthorised (lesk) releise. (Yes in Calton 13 of the <br /> .igvcaCory Reconciliation Shccc) _._. <br /> List date, tank f, and amounC tar all variativas ;bat cxcccdcd the <br /> allowable liv�ica. ' <br /> Date Tank / Aawuat <br /> I. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> "diciopal dates/amouvca shall be concioucd on a separate sheet of <br /> paper 4nd accachcd. <br /> if chc source of the variation which cxcgcdcd allowabiq limits Cas dui: co <br /> s leak chc incj4Cnt shall , c rcpertgJ to S .J . L. H . p. EnvlrOnucncal ucalch <br /> Within 24 hours and an unauchoritcd release report submitted- <br /> the gUartefly iva.mary fcpoct shall b4 RuawitCcd within IS day* of the end of each <br /> quaft�f. <br /> QuJcC�:c,_ I - JJnuar� --� flarGh <br /> ( jartwf Z-Aprll J4111: <br /> QJCt1:r � - J.�ly --� 1e11CS�IN:f <br /> Q.64rccr 4 - October --> Ik:c4•�ph4:f <br /> Send Et); SAN JOAQUIN LOCM. 111:AI.Tli 1)1 :*•I'I( 1(:'I' <br /> "tockLon , CA 95201 '466 - 01bl <br /> Ili;'I, /40 111/80 <br /> r' <br />