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a U 11 JIT <br /> Ilk <br /> INVENTORY RECONCILIATION OCT 161989 <br /> QUARTERLY SUMMARY REPORT FORM ENVIRONMENTAL HEALTH <br /> PERMITISERVICES <br /> FaciLitY flame: Morton Paint Company MR <br /> Facility Address: 38 W. Sonora Street-Stockton . CA 95203 <br /> Telephone : ( 209 )466-4541 <br /> Person Fi �� <br /> Report -y-MIL 61na"4 vtr <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 CO an unauthorized (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank f, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank R Amount <br /> 1. /6-/'2-0 aZ _ <br /> Z. /FJ v; <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 allowable Limits was due to <br /> a leak the incident shall be reported to S .,J .L .H . D . Environmental licaIth <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submitted within 15 days of [he end of each <br /> quarter. <br /> Quarter I - January --) March <br /> Quarter 2 - April --) June <br /> Quarter ) - July --> September <br /> Quarter 4 - October --) [k cember <br /> Send to: SAN JOAQUIN LOCAL HEALI-H DISTR1C-1- <br /> 1601 E . Haze 1 < tui , P . 0 . HOx 2()09 <br /> SLockton , CA. 115201 466 -6781 <br /> JC. 40 10/ 86 <br />