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4-10-89 INVENTORY RECONCILIATION APR 111989 <br />QUARTERLY SUMMARY REPORT FORM <br />r: TA1. N r f <br />1'StaMIT/SERVJCr-q <br />Facility Name; 13 S S Company <br />F'aciIity;Addreax: 639 W. Cla St. <br />Stockton, a.95206 <br />Telephone: 209---947-M/- <br />Person <br />09-9 -Person Filing <br />Report Boyd ' Groves <br />I hereby certify under penalty of perjury that all inven <br />the above .enc tory variations for <br />ioned fxc.ility :dere Within the allowable limits for this <br />quarter. (No in Column 13 of the inventory Reconciliation Sheet) <br />QInventory variations exceeded the allowable limits for thisuar <br />hereby certify under penaltyof perjury y efor t ter' I <br />he as not due to an unauthorized (leak)releiseth(yes iaColumn 13 Ofrtheioa <br />vas <br />Reconciliation Sheet) <br />List date, tank It and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank f Amount <br />1. <br />z. <br />3. <br />4. <br />S. <br />Additional dates/amounts shell be car&tiaued on a separate sheet of i <br />Paper and attached. <br />if the source of the variation which.exceeded al-lowsbie limits was due to <br />a leak the incident shall be reported to S.J.L.H,D, Environmental !Health <br />Within 24 hours and an unauthorixCd release report submitted. <br />The quarterly summary report shall be nubmit <br />quarter. ted within IS days of the end of each <br />-~` <br />atter 1 - Januar Hacch <br />Quarter 2 - Y -- <br />April -- unc <br />Quarter 3 - July --> Scptemhr.c <br />Quarter 4 - October --) DLccmber <br />Send to: SAN JOAQUIN LOCAL. HEAL11i DISTRICT <br />160 1 E.. !laze 1 t Hyl , t' 0. (Sox 2009 <br />7• 40 10/86 Stockton, CA 95201 466-67bi <br />