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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Nanej DELICATO VINEYARDS Task 0 <br /> EDiesel <br /> t <br /> 1 10 000 s <br /> Facility Addresst 12001 So. Highway 99 2 10,000 Gas <br /> Manteca, California 95336 -•10,000 <br /> Telephone : (209) 982-0679 *'-AND ND OTHERS** <br /> Person Filing Richard Larson <br /> Report Chief Accountant <br /> Q f hereby certify under penalty of perjury that all inventory variations for <br /> the above oentioncd facility were within the allowable limits for this <br /> tuarter. (No in Column 13 of the laveatocy Reconciliation Sheet) <br /> ❑ Inventory variations exceeded the allowable limits for thin quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was Oct due to so unauthorized (Leak) release. (Yes in Column 13 of the <br /> 1 laveatory Reconciliation Sheec) 1 1 <br /> List date, tack f. and smounc for all variations that exceeded the <br /> allowable limits. <br /> Date <br /> Tack I Amount <br /> 1. OCT <br /> 2. <br /> ENV, F1 Fir;1LThI <br /> ]. PERPOIT/SERVICES <br /> 4. <br /> S. <br /> Additional daces/amounts shall be concioued on a separate sheet of <br /> Paper and at(aChed. <br /> if the source of ChC vaf la( lOn vhlch rxc,'edcd all,-able limits vas duc Co <br /> a leak the lnC(dcn( mull br rcpor(cd (n S .J . L . H . D . Environ n(al llcal ( h <br /> wthini <br /> 24 hours and an unau(ho r, ted release cepocc subai(ted. <br /> Quarterly 11m�ry report .hall be s,.bmi((ed within 15 days of the end of rich <br /> Qu.r(rr . <br /> QuaC(cr 1 - Jaau.ry __) M..rch <br /> Q.arcer 2 - April --> luno <br /> Quarccr 3 - July --> Scp(rml„•r <br /> Q.srcer 4 - oc(obcr --> Occ.•mhcr <br /> Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E . Va•zelilin . P .O Kom 7.009 <br /> S( ockcon • CA 95201 466 -67b1 <br /> 40 10/N6 <br />