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INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />4-6-90 <br />APR 9 r7q, <br />ENVIRONMENIFAL HEA! <br />1PER 1T/SERA C"ES <br />facility Hame: D S S Company <br />Tank 1F Site Product <br />facilitY;Address: 639 W. Clay St. OOGal unleade <br />Stockton, Ca. 000 Gal diesel <br />Telephone: 6 000 Gal diesel <br />Person Filing 1 000 Gal empty-remov <br />p <br />Re ort Boyd endin �r�vPs pending g <br />I hereby certify under penalty of perjury that all ARYcntory variations for <br />the above-cntioned facility were within the altovable to=_ts car this <br />,u$: ter. (110 in Colu-,n 13 of the Inventory Reconciliation Sheet) <br />❑ Inventory variations exceeded the: allowable limits for this quarter. x <br />hereby certify under penalty of perjury that the source for the variation <br />was not due to an Unauthorized (leak) release. (yes in Column -13 9C the.... <br />Iaventory Reconciliation Sheet) <br />List date, tank f, ,and amount foe all variations <br />Allowable li-% <br />that exceeded the <br />o, <br />Date Funk F Amount <br />4. <br />S. <br />Additional dates/amounts shall be continued on a separate sheet of <br />Paper and attached. <br />If the source of the variation which.cxceeded at'lowablc limits vas due to <br />A leek the incident shall be reported to S,J,L.H.D. Environmental health <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be Aubmitted within 15 days of the end of each <br />quArter. <br />Quarter I - January=- <br />) H.-Ircli <br />Q*aarccr 1 - April --> June <br />Quarter ) - July --> septemh<:r <br />Quarccc 4 - October --> Mecember <br />Send to: SAN JOAQUIN LOCAL' HEALTH DIST ItICT <br />160 l E. _ 11a7r P-0.- Box 2009 <br />Stockton, CA 95201 466-G7b1 <br />�' 40 10/86 <br />