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LIST TTE, JANK # AND AMOU1vTF0RALL VARIATIONS <br />THA -r EXCEED THE ALLO"BLE LIMITS. <br />Date <br />Tank # <br />Amount <br />Explanation <br />Step V <br />New reconciliation <br />performed. <br />Step 3 <br />9r <br />Py /// <br />-Z 1+2 <br />X87- <br />Ea2a.41 iN <br />'4-7/.H2 <br />situation. <br />G 33 <br />Y77, - <br />"r -1-// <br />inspected for leaks. <br />/z j- <br />r�.-a <br />1 r <br />4- 2 <br />13 ko q 170 <br />- -ZX-e a )► ahi A <br />6-/ <br />//-3 <br />6-q <br />6 <br />/V.9 <br />3 <br />Y- /o , <br />z <br />7-/C1-- <br />1 <br />ly <br />OUT OF TOLERANCE <br />INVESTIGATIVE STEPS <br />StepReview <br />Records. <br />Step V <br />New reconciliation <br />performed. <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />Records review from <br />- <br />the last stable <br />situation. <br />Step 5 <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />p , <br />calibrated. <br />Step 7 <br />Piping hydrostatically <br />tested. <br />Step 8 <br />Underground storage <br />tanks precision tested. <br />Step 9 <br />Additional investigation <br />as required by Shell <br />or the local agency. <br />This quarterly summary report <br />shall be submitted within 15 days <br />after the end of each quarter. Check <br />the quarter you are submitting <br />❑ Quarter 1 — January thru March <br />Submit by April 15 <br />LTJ Quarter 2 — April thru June <br />Submit by July 15 <br />❑ Quarter 3 — July thru September <br />Submit by October 15 <br />--� Quarter 4 — October thru December <br />Submit by January 15 <br />Send to (Local Agency): S'll Al' ,r1 <br />�ln6 <br />4 Z.- <br />KEEP <br />1KEEP COPIES OF?THIS FORM FOR YOUR RECORDS <br />ATURE DATE <br />