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9— - <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Facility.Name: PUBLIC WORKS <br />P:cili '"dress 1810 E. HAZELTON <br />Y'STOCK3ON; CA 95205 <br />Telephone: ( 209 ) 468-3074 <br />Person Filing JUNE OKUBO <br />Report <br />r,r- <br />Tank f <br />Sizer <br />Prauct <br />1 <br />:2,000 <br />NO LEAD <br />2 <br />121-000 . <br />REGULAR <br />• 3': <br />}• • 10 ,•000 <br />D IE SEL <br />3. <br />2-8-90 <br />2 <br />226 <br />4. <br />3-5-90 <br />2 <br />339 <br />5. <br />0 I hereby certify ander penalty of perjury that all inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />quarter. (.No in Co.2%=- Dof 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 />bras not due to an unauthorized (leak) releise. (Yes in Column 13 of t:e <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for all variations that exceeded the <br />allowable limits. <br />Additional dates/amoucts shall be continued on a separate sheet of <br />paper, snd zr[mched. <br />Ef the source of the variation which.exceeded al-lowabte limits was due to <br />A leak the incident shall be reported to S.J.L.H.O. Environmental Health <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be xubmitted within 15 days of the and of each <br />Quarter_ <br />Quarter <br />Date <br />Tank f <br />Amount <br />i_ <br />2-15-90 <br />1 <br />111 <br />2. <br />2-6-90 <br />2 <br />173 <br />3. <br />2-8-90 <br />2 <br />226 <br />4. <br />3-5-90 <br />2 <br />339 <br />5. <br />1601 E. lfaze l t on . P.O. <br />Rox 2009 <br />Additional dates/amoucts shall be continued on a separate sheet of <br />paper, snd zr[mched. <br />Ef the source of the variation which.exceeded al-lowabte limits was due to <br />A leak the incident shall be reported to S.J.L.H.O. Environmental Health <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be xubmitted within 15 days of the and of each <br />Quarter_ <br />Quarter <br />1° <br />January March <br />Quarter <br />2 <br />- April --} June <br />Quarter <br />3 <br />- July --} septemb4:r <br />Quarter <br />4 <br />- October ---} December <br />Send to: <br />SAN JOAQUIN LOCAL HEALI.1i DISTRICT <br />1601 E. lfaze l t on . P.O. <br />Rox 2009 <br />Stockton. CA 95201 <br />466-6761 <br />EH 23 019 <br />10/86 <br />