Laserfiche WebLink
V-C4 <br /> INVENTORY RAN NCIk@XTIQN QtZ7� ���� <br /> 1�9� <br /> QUARTERLY SUMMA <br /> WA <br /> r. _ TH <br /> S VIV L �S-Uf <br /> Facility. Name: �QV S ) -IVJ-/A/t /YI//Y/ — Tank I . <br /> Siu. Product <br /> Facility,Address; _ � L� v �¢vr 2: °� <br /> Telephone : <br /> Person Filing <br /> Report 0 N�� <br /> I hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Column 13 of the Inventory Reconciliation Sheet) <br /> QInventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> vas not due to an unauthorized (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) _ <br /> List date, tank 1, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank f Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amouats shall be continued on a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. exceeded at-lovable limits was due to <br /> a leak the incident shall be reported to S .J .L. H . D. Environmental Health <br /> WLChin 24 hours and an unauthorized release report submitted. <br /> The Quarterly summary report shall be Fubmitted within 15 days of the end of each <br /> Quarter. <br /> Quarter I - January --) Harch <br /> Quarter 2 - April --> June <br /> Quarter 3 - July --> Septcmhi:r <br /> Quarter 4 - October --> December <br /> Send to: SAN JOAQUIN LOCAL H.E:ALTH DISTRICT <br /> 160L L. Haze 1 L<in , P . 0 . Box 2009 <br /> Stockton , CA 95201 466-6781 <br /> ,:T 40 10/86 <br />