Laserfiche WebLink
INVENTORY RECONCILIATION JAN 1 <br />QUARTERLY SUMMARY REPORT FORK c� �`. , rc� <br />FaciLity.Hame: SAN JOAQUIN COUNTY PUBLIC WORKS <br />Facility 4ddress: 1810 E. HAZELTON <br />Telephone: 468-3074 <br />Person Filing <br />Report JUNE OKUBO <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 />Inventory variations exceeded the allowable Limits for this quarter.- I <br />hereby certify under penalty of perjury that the source for the variation <br />was not due to an unauthorized (leak) releise. (Yes in Col 1 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank i, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank f Amount <br />1. _1 2-21-88 2 103 <br />2. <br />3. <br />4. <br />5. <br />Additional dates/amoucts shall be continued on a separate sheet of <br />Paper and attached. <br />If the source of the variation which exceeded allowable 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 1 - January --> March <br />Quarter 2 - April --> June <br />Quarter 3 - July --> SCpEeMh4!r <br />Quarter 4 - October --) Clecember <br />Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Hazelton. P.O. Rox 2009 <br />Stockton, CA 95201 466-6761 <br />EH 23 019 10/86 <br />