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7-9-90 <br />RECEIVE <br />i. <br />INVENTORY RECONCILIATION JUL 11 <br />QUARTERLY SUMMARY REPORT FORM ENVIRONMENTACHEh,- j, <br />PERMIT/SERVICES <br />Facility dame i D S S COMPANY <br />Tank 1: Si=c Product <br />PacLlity;Address: Gi 10,000 GAL UNLEADE <br />639 W. CLAY ST_ 1 10,000 GAh DIESE <br />STOIE''I CA. 95206 D2 6,000 GAL DIESEL <br />Telephone: 948-0302 WASTEOIL1, 000 GAL EMPTY -R <br />Person Filing -- <br />PENDIN <br />EMO <br />Report BOYD GROVES <br />X I hereby certify under pe <br />nalCy of perjury that all inrento va <br />rion <br />the above-entioned facility were within the allowable limits foratithis6 for <br />2u+!rter. (Flo i:� <br />Column "0C C the Inventory Reconciliation Sheet) <br />ElInventory variations exceeded the allowable limits for this quarter. <br />hereby certify under penalt of perjury q I <br />was no du Y. per'ur that the source for Use variation <br />t e to an uaauthorired (leak) releise. (Yes in Column -13 qf. the .. <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for all variations that exceeded the <br />Allowable limits. <br />Date Tank f Amount <br />z. <br />3_ <br />4. <br />5. <br />Additional dates/amounts shall be continued on a separate sheet of <br />paper and attached. <br />if the source of the variation vhich. exceeded allowable Limits was due to <br />a leak the incident shall be reported to <br />Within 24 hours and an unauthorized release•report {�D bmiitted��ntal llcalth <br />the Quarterl <br />quartet. my sumary report shall be Fubmittcd within 15 days of the end of cacti <br />Quarter 1 - Januar ) liarcll <br />r =- <br />Qvartcr 2 - April --) Jun(! <br />Quarter I - July --) Septcmhi:r <br />Quarter 4 - Octobcr --) lh:ccmber <br />Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />160 L E.. liaze ! t (iii ; ' P.O. Ilex 2009 <br />Stockton, CA 95201 466-67bL <br />�. 40 10/ti6 <br />