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JULY 6, 1992 <br />NNYENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Facility flame; D S S COMPANY <br />JWDIE <br />uct <br />Yacility;Addccss; <br />639 W. CLAY STREET. <br />STOCKTON, CA. 95206 <br />Telephone: 209-948-0302 <br />Person Filing <br />Report BOYD GROVES <br />I hereby certify under, penalty of perjury that all inventory variations for <br />the above dentioned facility vete within the allowable limits for this <br />quarter_ (No in Column i3 of the Inventory Reconciliation Sheet) <br />El <br />Inventory vaciatioas exceeded the allovable limits for this quarter. <br />hereby certify under penal= of perjuryor the e=ar. <br />use <br />not due to an unauthorised (leak) [c leiseth(YesuinCCOlumu e3 9frthe��n <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount <br />for all variations that exceeded the <br />allowable limits. <br />Date Tank f Amount <br />1.� jl,4a'4 a <br />3. JUL 0 7 1992 <br />I NMENTAL HEALTH <br />4. lfVl <br />S. <br />Additional dates/amouats shall be continued on a zepzrate shect of <br />Paper and attached. <br />lE Che source of the variation vhich.excceded allowable limits vas due to <br />At leak the incident shall be reported to <br />Within 24 $,J.L.H.D, Envicvnmental Ucalth <br />hours sod -in unauthorized release report submitted. <br />The qusrtcrly summary report shall be Rubmitted withih 15 days of the end of each <br />quarter. <br />Quarter 1 - January---> March <br />Q�sctcr 2 - April --> June <br />Quarter 3 - July --> septemhc r <br />Qvarcer 4 - October --> <br />tkccmbc r <br />Send co: SAN JOAQUIN LOCAL' -HEALTH .D1STIZICT <br />1601 E.. lfaze 1 t <��i , p. 0 . it -ox 7009 <br />Stockton, CA 95201 466-67b1 <br />1. 1-0 10/116 <br />