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INVENTORY RECONCILIATION RECEIVEO <br /> QUARTERLY SUMMARY REPORT FORM APR 2 4 ?9°0 <br /> ENVIRONMENTAL HEALTH <br /> PPPNAIII <br /> Facility Name: DELICATO VINEYARDS Tank i Size Product <br /> _ <br /> Facility,Address: 12001 S0. Hwy 99 12 1 10 000LeadedGas <br /> X10,000. U-n-1-e-ad-eT7as <br /> MANTECA, CA 95336 3 :10, Diese <br /> Telephone : (209) 982-0679 **AND NO OTHERS** <br /> Person Filing <br /> Report Robert L. Norman <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 /> Inventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> vas not due to an unauthorized (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank 1, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank R Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amounts chill be continued on a separate sheet of <br /> paper and attached. <br /> If the source of the variation which. exceeded allowable limits was due to <br /> a leak the incident shall be reported to S .J .L.H .D. Environmental Health <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 I - January_._) Marcty- /47) <br /> Quarter 2 - April --> June <br /> Quarter 3 - July --) September <br /> Quarter 4 - October --) December <br /> Send to: SAN JOAQUIN LOCAL. HEAL1•li UIS'1'HIC'1• <br /> 1601 E. liaZelL011 , P .O . liox 2009 <br /> Stockton , CA 95201 466-6781 <br /> 11GT 40 10/86 <br />