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.+.+v o 111 rKVrl <br /> P. d <br /> SAN�AQIIIN COUNTy PUBLIC HEALTJ& 1 VICES <br /> ENVIRONMENTAL HEALTH DrVISION <br /> California UST NNTORRegulatECONCILIAiIOON RZpORT <br /> (J ) <br /> Facility Name 17Lti BOW6� Paid L .6W>7 � <br /> Address Li, ( aLf /`]v" <br /> City <br /> aAll inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Angulations, <br /> Division 3 , Chapter 16, Section 2646, for the 12 month period from <br /> � 7'1 I 19 ")5 to jD`cc- ; r 19 `lam. <br /> ❑ Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK 0 / PRODUCT AMOUNT (Gallons) <br /> I <br /> I <br /> Submit raport within 15 days following the and of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JOAQCTM CODNTy pUBLIC BEALTN SERVICES <br /> MIVIROM4ENTAL HEALTH DrVISIox <br /> P.O. BOY 388 <br /> STOCZTON, CA 95201-0388 <br /> 1 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 /> Fact ity Tank operator/Owner Data <br /> EH 2J 019 8-1-92 <br />