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l <br />INVENTORY RECONCILIATION <br />ANNUAL SUMMARY REPORT FORM <br />Year: <br />Facility: <br />Address: <br />1995 <br />Beacon Station #1-641 <br />1210 Hammer Lane <br />Stockton, CA 95210 <br />I hereby certify under penalty of perjury that: <br />Tank # <br />Size <br />Product <br />1 <br />10000 g <br />Unleaded <br />2 <br />10000 g <br />Unlead Plus <br />3 <br />10000 g <br />Unleaded <br />4 <br />10000 g <br />upreme <br />All inventory reconciliation data for this year was within the allowable <br />variations (NO entered at the bottom of all Inventory Reconciliation Sheets). <br />FX Inventory reconciliation data for this year was not within the allowable <br />variations for the months listed below (YES enter at the bottom of the <br />Inventory Reconciliation Sheet). <br />Month Tank # Amount Tank # Amount Tank # Amount <br />January <br />February <br />March <br />April <br />May <br />June <br />Jul <br />August <br />September <br />October <br />November 4 Over 10g <br />December <br />, nature <br />Operations and Environmental Coordinator <br />Title <br />Jerry Unruh <br />Print Name <br />5 -Jan -96 <br />Date <br />invrpt Submit report within 15 days following the end of the calendar year <br />