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INVENTORY RECONCILIATION JAN 5 <br /> QUARTERLY SUMMARY RFPORT FORM %I1NMENTALHEALTH <br /> Facility Name: San Joagiin Lumber Co. Tank i Size Product <br /> I Gas <br /> Facility Address: 235 W. S cotts Ave. 2 5000 Diesel <br /> Stockton, Ca. <br /> Telephone : 465-5651 <br /> Person Filing <br /> Report Wa. Schneider <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 /> E] Inventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> was not due to an unauthorized (leak) releise. (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 / Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amounts shall 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 14 hours and an unauthorized release report submitted. <br /> The Quarterly su—iry report shall be submitted within 15 days of the end of each <br /> quarter. <br /> Quarter I - January --) March <br /> Quarter 1 - April --> June <br /> Quart July --> September <br /> atter 4 October --> December <br /> Send to: SAN JOAQUIN LOCAL HEALTH UISTK ICT <br /> 1601 E . Hazeluun , P .O . Ilox 2009 <br /> Stockton , CA 95201 466-67b1 <br /> UCT 40 10/86 <br />