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INVENIORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FUR14 <br /> Facility Namet y eli 7?0k Ufa ri-� Tank I Size Product <br /> / lo�pao U.v/era�l�{ <br /> Facility Address: c;?Il/ AIA,w VVlZ e a 'zQ-ods' 1w/Gala/ <br /> ,� dere Pe. 9fatu Oon _['jebg"Ihn- <br /> Telephone ! 1?4/ 2D// y riuJ•0dd "` <br /> Vernon Filing f/q. d0e <br /> Report 00t u <br /> 7 ag <br /> CV-0 <br /> I 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 in Column 13 of the Inventory Reconciliation Sheet) <br /> FJInventory variations exceeded the allowable limits for thin quarter. I <br /> hereby certify. under penalty of perjury that the source for the variation <br /> was not due to an unauthorized (leak) release. (Yen in Column 13 of the <br /> Inventory Reconciliation sheet) <br /> List dater tank /, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank / Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amounts shall be continued on a separate_ hhect of <br /> paper and attached. <br /> If the source of the variation which exceeded allowable limitq wnq dve to <br /> a leak the incident shall be reported to S .J .1_ 11. 1) , F.nvironmeotat 11calth <br /> within 24 hours and an unauthorized release report submitted. <br /> the quarterly summary report shall be submitted within 15 days of the end of each <br /> quarter. <br /> Quarter ( - January --> Harch <br /> tr,arter 2 - April --> June <br /> trl1r_tcc-4, - July --> September <br /> 'Quarter 4 r October --) December <br /> Send to! _--- SAN JOAQUIN LOCAL IICAI;1.1i ULSTRLC-1' <br /> 1601, F . 11azelt.un , P .O . Box 2009 �} FEB 221989 <br /> Stockton , CA 95201. 466-6781 <br /> DICT 40 10/86 ELIVIRON.M, L HEALTH <br /> PERM!: <br />