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INVENTORY w <br />QUARTERLY POROR <br />racLUty. Name: PUBLIC WORKS 'fink # _Size <br />: <br />TAcL1kq Addresd: 1810 E. HAZELTON 1 12 0002 12,000 <br />sTncxmON, CA 95205 3' 10•,000 <br />Telephone: (209) 468-3074 <br />Person Filing <br />Report June Okubo <br />Product <br />NO LEAD <br />L 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. (Ko in Column 13 of the Inventory Reconciliation et) <br />X Inventory 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 unauthorised (leak) release. (Yes in Column 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank Amount <br />1• 9-4-91 2 289 rbc <br />2. 9-25-91 2 187 <br />3.q <br />4. \ <br />5. e z, <br />Additional dates/amounts shall be continued on a separate sheet of <br />Paper and attached. <br />if the source of the variation which. exceeded al -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 />the quarterly summary report shall be submitted within 15 days of the end of each <br />quarter. <br />Quarter I - January --: march <br />Quarter 2 - April --, June <br />4sarter l - July --> September <br />Quarter 4 - October --> December <br />Send to: SAN JOAQUIN LOCAL HEAL1'1i D1STRICT <br />1601 E. Hazelton. P.O. Box 2009 <br />Stockton. CA 95201 466-67bi <br />EH 23 019 10/86 <br />