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INVENTORY RECONCILIATION APR <br /> QUARTERLY SUMMARY REPORT F0.09VIROMENTAL HEALTH <br /> PERMIT/SERVICES <br /> FaciLity Hume: P4lQ OCke <Cy Tank Sise- Product <br /> . <br /> >Pdc£tity�Addrena: � �' � 00 a ii <br /> oce cl 6.,.rel <br /> Telephone : <br /> Person Filing <br /> Report - <br /> hereby certify under penalty of perjury that all inventory -variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No is Column 13 of the laventory Reconciliation Sheet) <br /> QInventory variations exceeded the allowable limits for this Quarter. I <br /> hereby certify under penalty of perjury that the source far the variation <br /> was not due to an unauthorized ( leak) release. (Yens in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank I., and.-amount for alL variations that exceeded the <br /> allowable lic+its. <br /> Date Tank # Arsount" <br /> z_ <br /> 3. <br /> 4_ <br /> 5. <br /> Additional dates/amounts 91,211 be continued on a separate sheet of <br /> paper and attached. <br /> It the source of the variation -hich. exrrr.ded :, llovable limits was due to <br /> j leak the incident stlall be reported t« ; J T1{ p Environmental Uczl[h <br /> WA thin 24 hours and an unauthoritrd release report submitted. <br /> The quarterly a' <br /> u-1 report shall be nubmt( tcd within 15 days of the end of Cath <br /> qu2rC`r. ' <br /> Quarter I - January --) March <br /> Qjarter 2 - Apr iI -> June <br /> Quarter 3 - July --> >epcemts4-r <br /> Quarter 4 - October --) fh,cemj)cr <br /> Send to' SAN JOAQU I-tq 1_0(;Ai. HEAI_T'li i) l 'TH I CT <br /> 1601 !-: . H.izc li ,iii , P - 0 . 1i,, )(109 <br /> Stockton , CA 95201 4(01 -67b1 <br />