Laserfiche WebLink
/o <br />QUARTER( INVENTORY &.PORTING <br />Facility Name:i+cr'a1�.�� <br />Facility Address: /Z / <br />City: Z o <br />County: AJ cZ®! &ui <br />State: (,A/,- <br />hese <br />-A <br />hese were inventory variations that <br />0/'exceeded the allowable limits for this <br />quarter. <br />Tank # <br />Size <br />Product <br />New reconciliation <br />Explanation <br />performed. <br />Z <br />'f;-0.0 0 <br />S <br />Records review from <br />O <br />the last stable <br />Step 8 <br />setr 0 <br />. <br />tanks precision tested. <br />Step 9 <br />Additional investigation <br />as required by Shell <br />d- <br />252 <br />Waste Oil <br />I hereby certify that all product level variations <br />❑ for the above mentioned facility were <br />within allowable limits for this quarter. <br />LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS <br />THAT EXCEED THE ALLOWABLE LIMITS. <br />Date <br />Tank # <br />Amount <br />New reconciliation <br />Explanation <br />performed. <br />Step 3 <br />6 -2- <br />-Fz <br />Records review from <br />3�19.2 <br />the last stable <br />Step 8 <br />situation. <br />. <br />tanks precision tested. <br />Step 9 <br />Additional investigation <br />as required by Shell <br />d- <br />252 <br />S 7-1Cle <br />//-23 <br />3 <br />"% l% <br />s i iC Ic L; 2 20.2 . <br />�• x -I <br />l� '� <br />��S <br />� <br />opt ar`' ,cl�h <br />S l dr mrlu4k sh on <br />/2--/ q <br />12 <br />1. <br />/6/ <br />WINEFIV <br />I Fn <br />AN 2 9 999 <br />OUT OF TOLERANCE <br />INVESTIGATIVE STEPS <br />Step 1 <br />Review Records. <br />Step 2 <br />New reconciliation <br />Step 6 <br />performed. <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />Records review from <br />/,0,7+ct <br />the last stable <br />Step 8 <br />situation. <br />Step 5 <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />calibrated. <br />Step 7 <br />Piping hydrostatically <br />/,0,7+ct <br />tested. <br />Step 8 <br />Underground storage <br />. <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 />❑ 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- N 46'A &,,, A 941 <br />1601 <br />KEEP OPIES OF S FORM FOR YOUR RECORDS <br />DEA ERS NATURE DATE <br />