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F'aciLiCy Name; <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />D S S COMPANY <br />FaciIity,Addreas: 639 W. CLAY ST. <br />STOCKTON, CA. 95206 <br />Telephone: 209-948-0302 - <br />Person Filing <br />Report BOYD GROVES <br />xank ISiie <br />10 , 0� <br />Product <br />UNLEADED . <br />DIESEL <br />DIESEL <br />I hercby certify under penalty of peri, <br />the above ury that all inventory variAtions for <br />®cnCioned facility %ere within the allowable liaits for this <br />quarter_ (No in Column 13 of the Inventory Reconciliation Sheet) <br />❑ Inventory variations exceeded the allovable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />'*,as not due to an unauthorired (leak) releise. (Yes in Column..l3 of. the ._ <br />Inventory Reconciliation Sheet) <br />List date,tank 1, and amount for alt variations that exceeded the <br />allowrble limits. <br />Date Tank f <br />MR* <br />ount <br />ECEIVED <br />1_JAN 0 9 1992 <br />z.ENVIRONMEWAL ME LTH <br />3.PERM/ T/VICFS <br />4. <br />5. <br />AAditional dates/unouats shall be continued on a separate skeet of <br />Papcc and attached. <br />IE Che source of Che variation vhich.exceeded at -lovable limits vas due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental Ucalch <br />Within 24 hours and an unauthorized cc least report submitted. <br />The quarterly summary report shall be Rubmitted within 15 days of <br />quarter_ the end of cacti <br />Quarter I - Jaou+er � N.�reh . • <br />Q, -'.2C r 2 - April --> June <br />QUarccr 3 - July --) septemh<:r <br />Quarccr 4 - October --> Qcccmbcr <br />Scnd to: <br />SAN JOAQU IN LOCAL'. HEAL111 D 1 S -1-H IC -1- <br />1601 !:.. Ha7e 11, (ill , 1' .0: Box J009 <br />Stockton, CA '15201 466-67b1 <br />1,0 10/86 <br />