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i s <br /> 0 <br /> 4TH QTR. 1990 <br /> INVENTORY RECONC rt IAT r OM <br /> QUARTERLY SUMMARY RF.PORi FORM <br /> raciLLty Kase; Stockton AASF <br /> Tank / SizW-4 R'acilttr."dress: SUE #1 20, <br /> timson Rd. 2 20,00tockton CA. , 95 <br /> Telephone (20) 982-3880 <br /> Person Filing <br /> ReporC — SFr. Curt Lance' <br /> Thereby certify under penalty of perjury that all invcn <br /> the above mentioned facility were within the allowable liaitsvarifor Chia2 £or <br /> quarter. (No is columa 13 of the Inventory Reconciliation Sheet) <br /> Inventory variscioas cxceeded the allowable li"its for this quarter. t <br /> by <br /> wa4r9 not due perjury that the source for the voriatioa <br /> to as unauthorized certify wader penalty of(leak) <br /> Iavcotory Reconciliation Sheet) Celeste- (Yes is Column 13 of the <br /> List dates tack fa and amount for all varia icoa t at exceeded the <br /> r <br /> allowable !units. <br /> Oatc Tank E Aoouatk/°k <br /> • roA f <br /> 1 f y4 !'N A <br /> 4. <br /> S. <br /> "ditioaal dates/amauots shall be eontioued oa a separate sheet of <br /> Papec Ind attached. <br /> IE the source of the variation whist. exeeedcd allowable 1ic+iCs was du` to <br /> +� <br /> Leak the incident shall be eepoctcJ to S.J ,l..H,p. Eavi conacnea t Health <br /> within 24 hours and an unauthorized release report submitted. <br /> rhe quarterly su=aarr report shaft be RubmitCcd vithin IS days of the end of each <br /> quarter, c <br /> Quarter 1 _ January -_> Marc!® <br /> Qaacccr 2 • April __? Julie <br /> Quarter l - Juty -.? ,epCcmh.er <br /> Quarter 4 - October --> fkcc®ber <br /> . Scnd to: SAN JOAQUIN LOCA1. HEALTts UIS,I'KlC'1 <br /> 1601 £.. t:.'r.c•1 t tall , 1'.®. tt<:x lull') <br /> '®.0 <br /> Stockton. CA 115201 46(, G Jb 1 <br /> U�:1 ! nJ Jif► ' <br />