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INVENTORY RECONC IL IAT ION <br />QUARTERLY SUMMARY REPORT FORM <br />FacWtr Pant 1 Stce PcoducC <br />raGfiEty Addre�st � Vf/�r <br />`a v <br />Telephone: ( 1AF5 <br />Person Filing <br />Repor[ <br />L hereby certify Wader penalty of perjury Chat all,inventory variations for <br />tb2 above r.eacioaed facility were Within the al.Lowable limits far this <br />Amacter. (He is Columa 13of the Lo..catocy lteconciLiatioa Sheet <br />QEaventocy vaeiatiaaa exceeded the .11owable limits for tbis quarter_ I <br />bseceby certify Wader penalty of perjury Ch dc Che source for the v■ristiLCT I <br />team aoC due to so unauthorized (leak) releaac. (!Ccs Lia Column 13 of the <br />Lnveaeory Recoociliation Shecc) ENVIRONMENTAL HEALTH <br />PERMIT/SERVICES <br />List date, Cask 1. and aa.rsunc for all variacioa■ that exceeded the <br />allowable limita. <br />DatCe i30k / IlmouaC <br />Add 4Ctoaal daCea/amoasat� chal l be conCtaucd on a .cparacc ahcet of <br />pap�-_C and z.'(sChcd. <br />Che aouCCC Of ChC v4ri2(101 ..I++Els rvr.•r,1r+1 iil+,vahlc lt�IC3 '-3S <br />• leak Chc lnctdcn( ■hall tic rcl++rSr.f (,+ j }{ j) tnMtrnnaun(al SitSl€I+ <br />tiraCh�n Z<. hOur% 3n,( an un.i,.((tnr, re,l r.•lr.r +• /rl+nrr tuhn, CCc+1. <br />1,11C q..ar(Crly aumaury <br />7ua!(rr. <br />QvAC(Cr I - Janu•rr <br />Q•.ar[cr - October --> lkCrel+rr <br />SCn,d Ca: SAN JOAQU lr LUCAL HEA1.11; U I NI K I C1' <br />61 . - <br />SLocktnn, CA'9I 201 1.66-67bl <br />vi, 1s o i Cl / wl <br />