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"ECEIVED <br />INVENTORY RECOtICILIATION JAN 7 1992 <br />QUARTERLY SUMMARY REPORT FORM <br />ENVIRONMEN V Crc! �� <br />Facility Nz.c: I2 <br />Tank I <br />PAC. AdJ''Ire Product <br />icy ress: <br />Telephone: 7L2 S —3 t,2- Y��- <br />Person Filing <br />QL hereby certify under penalty of <br />t all iariti <br />the above ©eationed facility were with inytheaalLowablecntory limitsvforathiss for <br />quarter. (No in Column 13 of the Lavencory Reconciliation Sheet) <br />Inventory variations exceeded the allowable Limits <br />hereby certify under for this quarter_ I <br />was not due to an unauthorizedf(leak)perjurrelease. ( esthat theuin for the variation <br />Inventory Reconciliation Sheet) in Column 13 of the <br />List date, tank #, and amount for all variations that exceeded the <br />allowable limits. <br />Date Tank # ksount <br />S <br />3. <br />4. <br />Additional dates/amounts shall be continued on arate sheet of <br />Paper and attached. a 6ep <br />If the source of the variation which exceeded allowable limit.a was duL to <br />a leak the incident shall be reported to <br />within 24 hours and an unauthorired r�•LcasS J.L.Ireport DbmiCvtconmcntal Ilcal[t� <br />ted. <br />The quarterly summary report shall bar .ubmit[ed within <br />15 'I.'y; tit the end of -.ich <br />Quarcer 1 - January --> "arch <br />Q¢Iarter 2 - April -_> June <br />Quarcer 3 - July <br />:cptcmbr.r <br />--> f�eccmhcr <br />Scnd co: SAN .JOAQUIN LOCAI. IIEAL1'11 UISTRIC1- <br />1601 E.. haze 1 ton , 1' . 0 . QOx 2009 <br />S k <br />LILT 40toe ton, CA 9D201 466-6781 <br />10/86 <br />