Laserfiche WebLink
FacLUty. Name: PUBLIC WORKS <br />twciiity 4oddeedis 1810 E. HAZELTON <br />ST CKTON,� CA 95205 <br />Telephone: (209) 468-3074 <br />Person Filing <br />Report June Okubo <br />El L hereby certify under penalty of perjury that all inventory variations for <br />the above mentioned facility were vithin the allowable Limits for this <br />quarter. (No is Column 13 of the Inventory Reconciliation et) <br />Lnveatory variations exceeded the allowable limits for this goarter.' t . <br />hereby certify under penalty of perjury that the source for the variation <br />was dot due to as unauthorised (leak) release. (Yes is Caluaw 13 of the <br />toveatory Reconciliation Sheet) . <br />List date, tank /® and amount for all variations that exceeded the <br />allowable limits. <br />ditionsU-dates/amouctx shalt be continued on a separate sheet of <br />Paper and attached. <br />It the source of the variation uhich. exceeded at -lovable limits was due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental Health <br />Within 24 hours and an unauthorized release report submitted. <br />ne quarterly summary report shall be submitted within IS days of the end of each <br />quarter. <br />Quarter 1 - .January --1 Narch <br />Quarter 2 - April --? June <br />actec 1 - Jul ®-> Scptcsibrc <br />Quarter 4 - October --> dcccm <br />Se"d to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Ha ze l t4in a P.O. [lox 2009 <br />Stockton. CA 95201 466-61b1 <br />EH 23 019 10/86 <br />Date <br />Tank P <br />Amount <br />1. <br />10-14-91 <br />1 <br />179 <br />RECEIVED <br />2. <br />11-22-91 <br />1 <br />101 <br />JAN 0 9 1992 <br />3. <br />10-14-91 <br />2 <br />ENVIRONMENTAL L HEALTH <br />4. <br />10-25-91 <br />2 <br />188 <br />PERMIT/ alYKE a <br />5. <br />•10-28-91 <br />2 <br />109 <br />6. <br />12-31-91 <br />2 <br />549 <br />ditionsU-dates/amouctx shalt be continued on a separate sheet of <br />Paper and attached. <br />It the source of the variation uhich. exceeded at -lovable limits was due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental Health <br />Within 24 hours and an unauthorized release report submitted. <br />ne quarterly summary report shall be submitted within IS days of the end of each <br />quarter. <br />Quarter 1 - .January --1 Narch <br />Quarter 2 - April --? June <br />actec 1 - Jul ®-> Scptcsibrc <br />Quarter 4 - October --> dcccm <br />Se"d to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Ha ze l t4in a P.O. [lox 2009 <br />Stockton. CA 95201 466-61b1 <br />EH 23 019 10/86 <br />