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Facility <br />Address <br />SAN JOAQk, rg COUNTY PUBLIC HEALTH SEI --.,CES <br />ENVIRONMENTAL HEALTH DIVISION <br />ANNUAL INVENTORY RECONCILIATION <br />California UST Regulations, Article <br />SUMMARY REPORT'PVfRQfet41fjr <br />4, Section 2646 (y?At!j sL �EQ/ %fl <br />JAN <br />71All inventory variations <br />within allowable limits <br />Division 3, Chapter 16, <br />19 <br />for the above mentioned facility were <br />of Title 23, California Code of Regulations, <br />Section 2646, for the 12 month period from <br />to 19 <br />77 Inventory variations in excess of the allowable limits of Section <br />2646, occurred as listed below. <br />DATE <br />TANK # / PRODUCTCLcfi AMOUNT (Gallons) <br />C% <br />+rY <br />Submit report within 15 days following the end of the last month of the <br />12 -month period covered by the report. Report to be submitted to: <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOB 2009 <br />STOCKTON, CA 95201 <br />I certify under penalty of perjury, that all variations (if any) <br />exceeding allowable limits are indicated above (California Health & <br />Safety Code, Section 25299): <br />Facility Tank ?ter+ <br />EH 23 019 8-1-92 <br />/Owner <br />1--7y <br />Date <br />