Laserfiche WebLink
INVENTORY RECONCILIATIO <br /> UARTERLY SUMMARY REPORT FORM <br /> Facility Name: Cit Of Stockton Tank Size Product <br /> 1 12 ,0G0 no-lead <br /> Facility Address: 1465 S . Lincoln St . 12 000no-lead <br /> Stockton, 12 000 Diesel <br /> Telephoner _ 944-8305 <br /> Person Filing <br /> Report: Mike Thornton/Whse . Superv. <br /> I hereby certify under penalty of perjury that all inventory <br /> variations for the above mentioned facility were within the <br /> allowable limits for this quarter. (No in column 13 of the <br /> Inventory Reconciliation Sheet. ) <br /> Inventory variations exceeded the allowable limits for- this <br /> quarter. I hereby certify under penalty of perjury that the <br /> source for the variation was not due to authorized (leak) <br /> release. (Yes in Column 13 of the Inventory Reconciliation <br /> Sheet) . <br /> List date, tank i, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date TAnk _A Amount Reason <br /> 1. 9-9-91 1 +184 .4 Delivery <br /> 2 . 9-18-91 1 - +237 .8 Time of _Day <br /> 3 . 9-27-91 1 -109 . 8 Delivery <br /> 4 . 8-15-91 2 -196 .8 Delivery <br /> 5. 9-4-91 2 +103 .4 Delivery <br /> Additional-dates/amounts shall be continued on a separate <br /> sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April ----------->June <br /> carter - July ------------> eptembe <br /> Quaff 4 - Octo er --------->Decem er ECEN'I tD <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES 1991- <br /> ENVIRONMENTAL HEALTH DIVISION- <br /> 1601AL HEALTH <br /> 11�� . T <br /> E. Hazelton Ave. , P.,O. Box Q <br /> Stockton, CA 95201 ERMIT/SERVICES <br /> (209) 468-3420 <br />