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• ANNUAL STATIST140L INVENTORY ECCI TION (SIR) REPORT <br />Annual summary reports are required for retail and non -retail facilities <br />FACILITY NAME Quik Stop #124 PRODUCT Premium Unleaded <br />FACILITY ADDRESS 505 North Main Street TANK I.D. Number Tank No. 3 -PREM <br />CITY, STATE ZIP Manteca, CA 95336 <br />TANK OWNER/OPERATOR Quik Stop Markets, Inc. TANK CAPACITY 9,685 <br />LAST TANK TEST DATE PASS/FAIL LAST LEAK DETECTOR CHECK DATE PASS/FAIL <br />LAST PIPING TEST DATE PASS/FAIL LAST METER CALIBRATION CHECK DATE PASS/FAIL <br />FilAll monthly SIR results for the above mentioned tank at the above mentioned facility were "pass" for the twelve <br />month period from January, 1996 to December, 1996. <br />F-1Monthly SIR results showing "fail" or "inconclusive". occurred on the following months, in the listed amounts, for the <br />UST. If the SIR result for a month exceeded the SIR method's threshold or was inconclusive, appropriate corrective <br />actions described in Section 2646.1 must be taken. The local agency must be notified within 24 hours of receiving a <br />"failed" or "inconclusive" SIR report. <br />Summary of text results from monthly SIR reports. Complete for all 12 months. <br />* No Analysis Performed <br />** Negative Calculated Leak Rate indicates a Gain <br />Submit report within 15 days following the end of the last month of the twelve–month period covered by this summary report. <br />Send to: (local implementing agency)) <br />1 certifyRluANGLnder Enalt o ME r%y INat all SIR results listed above are as calculated. <br />2525 W. BURBANK BLVD. <br />11RBANK CA Q®5-2202 <br />Signature of Tank Owner/Operator or Agent Date <br />SWRCB — Amua1S1R.INV-02 <br />­">a\f <br />ME <br />:u}\` <br />N.\",. <br />\\liY', <br />.': <br />�{';i,v. ,\ i" \ <br />Y' "?\\a \ \ <br />? ; ',• "` R° :Xv\v'' `'^ f <br />© <br />1. � •. .. i <br />_�� <br />� <br />�. � •. <br />��- <br />m,•. <br />iii <br />, , <br />. <br />, , <br />, i <br />-- <br />* No Analysis Performed <br />** Negative Calculated Leak Rate indicates a Gain <br />Submit report within 15 days following the end of the last month of the twelve–month period covered by this summary report. <br />Send to: (local implementing agency)) <br />1 certifyRluANGLnder Enalt o ME r%y INat all SIR results listed above are as calculated. <br />2525 W. BURBANK BLVD. <br />11RBANK CA Q®5-2202 <br />Signature of Tank Owner/Operator or Agent Date <br />SWRCB — Amua1S1R.INV-02 <br />