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10-5-90 INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM 3rd Quarter <br />,Facility Name: D S S Company <br />Tank I : Sine Product <br />Facility;Address:10 000 Gal Unleaded . <br />P. 0. Box 6099 D1 1'0 000 Gal Diesel <br />_Stockton Ca 95206 D2 6 000 Gal Diesel <br />Telephone: 948-0302 <br />Person Filing <br />Report Boyd Groves <br />I hereby certify under penalty of perjury that all inYentory variations for <br />the above ■sectioned facility were within the allowable liaits for this <br />quarter. (No in Column 13 of the Inventory Reconciliation Sheet) <br />QInventory variations exceeded the allowable; limits for thisuarter. <br />hereby certify under penalt of Q I <br />was not due to an unauthorized (leak)rreleise. (Yen in Column -1 source for the variation <br />Inventory Reconciliation Sheet) 13 pf. the ... ... <br />List date, tank 1, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank I Amount <br />R- L <br />1._ <br />3. T <br />4. i ENVIP0N.11. EN' -,aL HEALTH <br />S. PERMI T t E �'w`I 't <br />Additional dates/ -mount, shall be continued on a separate sheet of <br />Paper and attached. <br />If the source of the variation which. exceeded allowable limits was due to <br />At leak the incident shall be reported to $,J,L.1i,D, Environmental !lcalCh <br />Within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be submitted vithih IS days of,the end of each <br />quarter. <br />Quarter I - January.--) Hircti <br />Q'Jartcr 2 - April --> June <br />Quarter 3 - July --) September <br />Quarter 4 - October --> Deccmber <br />Send to: SAN JOAQUIN LOCAL iEALTH' .UISTIticl, <br />1601 E. . Haze 1 t o1i P . 0.' Il()x 1t)Oq <br />Stockton, CA 915" 01 4 6 6 - 6 7 b I <br />1' <br />140 10/86 <br />