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Additional dates/amounts chap be continued on a separate sheet of <br />paper and attached. <br />It <br />the source of the variation v"ch.exceeded at -lovable Limits vas due to <br />a 1"k the incident shall be reported to S,J,L.It. D, Environmental lie aItI, <br />Within 214 flours and an unauthorized release report :ubmiCted, <br />The Quarterly summary report shall bt submitted vithih IS days of the end of each <br />QuArter_ <br />QvacCcr ( - January`- <br />) March <br />91-1aCCcr 2 - April --> June <br />Q,jartcr J - July --) Scptcmh<:r <br />QvArtcr 4 - October --) DCc mber <br />Send to: <br />SAN JOAQU IN LOCAL' HEALTH DISTRICT <br />160 1 1-.*. . 1laze I l crit , , p . 0 . 11Ox <br />2009 <br />SCockton, CA 95201 466-67bi <br />1' 1-0 10/66 <br />INVENTORY 1RECONCILIATION <br />JUL 149�7-5-91 <br />LVIRQRIMNTAI.=�EA�TH <br />QUARTERLY SUMMARY REPORT FORK <br />PERMIT/SERVICES <br />FacilitY Kamc: D S S Company <br />Tank <br />f Site Product <br />1'14clli.ty-'Addreas; 639 W. Clay St.'. G1 <br />10 000. unlea e <br />StoC ton, UU. JJLVD D1 <br />'10 000. diese <br />Telephone: D2 <br />'6,000 diesel <br />Person Filing 948-0302 <br />Report <br />Boyd Groves <br />i <br />❑X 1 hereby certify under penalty of perjury that all <br />the above eK ntioned facility were <br />inrento va 'a tioo for <br />within the allowable <br />quarter. (1{0 in Column 13 of the Inventory Reconciliation <br />liaits for thiss <br />Sheet) <br />inventory variati <br />herebons exceeded the allowable limits <br />uarter <br />q Z <br />for thisor <br />y certify under penalt of er'ur <br />vAs not due to tiat <br />an unauthorized (leak) rele,iaeth(yesuiaeColumaCle <br />Lavcatory Reconciliation Sheet) <br />lJ Qf <br />sthc�.�a <br />cedate, tank E, and amount <br />allowable for all variatioas that exceeded the <br />llolimits. <br />Datc Tank I Amount <br />z. <br />4. <br />S. <br />Additional dates/amounts chap be continued on a separate sheet of <br />paper and attached. <br />It <br />the source of the variation v"ch.exceeded at -lovable Limits vas due to <br />a 1"k the incident shall be reported to S,J,L.It. D, Environmental lie aItI, <br />Within 214 flours and an unauthorized release report :ubmiCted, <br />The Quarterly summary report shall bt submitted vithih IS days of the end of each <br />QuArter_ <br />QvacCcr ( - January`- <br />) March <br />91-1aCCcr 2 - April --> June <br />Q,jartcr J - July --) Scptcmh<:r <br />QvArtcr 4 - October --) DCc mber <br />Send to: <br />SAN JOAQU IN LOCAL' HEALTH DISTRICT <br />160 1 1-.*. . 1laze I l crit , , p . 0 . 11Ox <br />2009 <br />SCockton, CA 95201 466-67bi <br />1' 1-0 10/66 <br />