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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM JUL 71989 <br /> iFALTIH <br /> q -PV F <br /> Facility Name: 'Apmr ,r.TF gygA Yank 04 Size. Product <br /> 1000 GAL UNLEADGAS <br /> [acility Addcers; _1R6O0 CORRAL HOLLOW RD 2 • 1000-GAL.. I •b , <br /> TRACY CA 95378 01105 <br /> Telephone: 415 455 5918 <br /> Person Filing <br /> Report WORM FOSTER <br /> QF hereby certify under pcoalcy of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (Ho in Colum, 13of the Inventory Reconciliation Sheet) <br /> Inventory variaticas exceeded the allowable limits for this quarter. ' I <br /> hereby certify under penalty of perjury that the source for the variation <br /> vas not due to an unauthorized (leak) releise. QYes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date» tank i, and amount for all variations that exceeded the <br /> allowable limits. > <br /> Date Tank @ Mount <br /> i <br /> 1. <br /> I . <br /> 2. <br /> 3. <br /> 4. <br /> Additional datcs/amounts shall be continued on a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. exceeded allowable limits was due to <br /> a leak the incident shall be reported to S.J .L.H.D. Environmental Ucalth <br /> Within 24 hours and an unauthorized release report submitted. <br /> ncc Quarterly summary report shall be submitted within 15 days of the end of each <br /> quarter. <br /> t I January .•_> March <br /> arter 2 April --> June <br /> Quarter 3 - July --D ,Septcmber <br /> quarter 4 - October --> December - <br /> Send to: SAN JOAQUIN LOCAL HEAL1'II DISY'R1CT <br /> 1601 E. liazelLnll , P.O . Bnx 2009 <br /> Stockton . CA 95201 466-6761 1 <br /> T 40 10/86 <br />