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AP44 <br /> RI <br /> R � . <br /> INVENTORY RECONCILIATION eNPR© /VME� 1 !^"7 <br /> QUARTERLY SUMMARY REPORT FORM �RN1Ir//S EA1tri <br /> e�� <br /> BaciLitT Rase: Morton Paint company Tank <br /> Stxe Product <br /> lacilitr Address: 38 W. Sonora Street <br /> kion CA 95203 <br /> Telephone : _ 209 )466-4541 <br /> Person Fi1i g <br /> Report d- ar� <br /> I hereby certify under penalty of perjury that all inventory variations for <br /> the above seationed facility, were vithin the allowable limits for this <br /> quarter. (No in Columna l3 of the Inventory Reconciliation Sheet) <br /> QInventory 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) 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 I Amount <br /> 2. <br /> 3. <br /> 4. <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 al-lovable limits was due to <br /> a leak the incident shall be reported to $ J .L .H . D. Environmental lira l th <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be Kubmitted within 15 days of Che end of each <br /> quarter. <br /> Quarter I - January --) March <br /> Quarter 2 - April --> Jutle <br /> Quarter 3 - July --> Scptemher <br /> Quarter 4 - october --) flrccmber <br /> Send co: SAN JOAQUIN D)CAL HEALTH DISTRICT <br /> 1601 E . l:�� c' Z t rral , !' , 0 , 1j()x 1()()9 <br /> SLockCon , CA 15201 460 -6761 <br />.ic: 40 10/86 <br />