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11 <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Facility Nam,: <br />9 f <br />Facility <br />Telepho <br />Person <br />Report <br />I hereby certify under penalt Of perjury <br />that all _ <br />ti <br />the above mentioned facility were within the Allowablelimitsntory this for <br />quarter' (No :n Coluaan l3 of the Inventory Reconciliation Sheet) <br />Inventory variatioas exceeded the allowable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />was not due to an unauthorized (leak) relcise. (Yes is Colum 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for all variations that exceeded the <br />allowable Limits. <br />Date Tank f Amount <br />Z. <br />3. <br />4. <br />S. <br />Additional dates/amouacs shall be continued on a separate sheet of <br />Paper and aCCachcd. <br />If the source of the variation which exceeded allowable limits was due: to <br />At leak the intidenc shall be reported to S.J.L•H.D. <br />Envir <br />Within 24 hours and an unauthorized release report submiCtedontal Ucalch <br />The Quarterly sua—ary rrport shall be Kubmicted within 15 days of the end of c.,ch <br />quarter, <br />J2QUArY H•e r C Pa <br />Q,srt�tr 1 - <br />Ali r► t --) Juni. <br />Quarccr ) - July --> ScpCcmh,•r <br />Q"arcer 4 - <br />Uccobcr --) [k�ct•mbcr <br />Send to: SAN ,J0AQl1 IN LOCA 1. It EAL-1'1i U I S'l*R I C'I• <br />1001 1:. I:;j%C•I(4111, 1'.(). ltox L001) <br />1• 40 10/iih :>tockton. CA 95201 460-67bl <br />