Laserfiche WebLink
QUARTERLY INVENTORY REPORTING <br /> J , 4ts hk Tank ! Size Product <br /> Facility Name: C" -i1 <br /> Facility Address: �� `" a <br /> City: � S-00o c <br /> County: S c �C Cil <br /> State: <br /> Waste ail <br /> -VNur <br /> I hereby certify under penalty of perjury that all product <br /> level variations for the above mentioned facility were JAN 0 8 <br /> within allowable limits for this quarter. 1 <br /> Inventory variations exceeded the allowable limits foc-NVIRONMENTAL NE;",LTh <br /> F] this quarter. I hereby certify under penalty of perjury PERMIT/SERL"oCEs <br /> that the source for the variation was NOT due to an <br /> unauthorized (leak) release. <br /> List date. tank E and amount for all variations <br /> that exceed the allowable limits <br /> Date Tank Amount Date Tank E Amount <br /> The quarterly summary report shall be submitted within 15 days <br /> of the end of each quarter. <br /> Quarter i — January thru March — Submit by April iS <br /> Quarter 2 — April thru June Submit by July iS <br /> Quarter 3 — July thru September Submit by October 15 <br /> Quarter 4 — October thru December — Submit by Janaury <br /> Send To (Local Agency : <br /> KEEP COPIES OF THIS FORM FOR YOUR OWN RECORDS <br /> DATE MAILED ,/ Z/ /r <br />