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INVENTORY RECONCILIATIOM <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: Morton Paint Company Tank t Sise <br /> Product <br /> Facility Addresa: 38 W. Sonora Street 5 <br /> -Stockton , CA 95203 <br /> Telephone : 2091466-4541 <br /> Person F ng <br /> Report <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 11 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 /> was not due to an unauthorized (leak) release. (Yes in Column 11 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 It Amount <br /> .2- r <br /> 3. <br /> 4. <br /> 5. <br /> Additional dacca!amouccw shall be continued on a separate sheet of <br /> Paper and attached. <br /> If the source of the variation which. eaceeded allowable limits was due to <br /> a leak the incident shall be reported to S .J . L. H . D . Environmental llcalth <br /> within 24 hours and an unauthorized re Lcase report submitted. <br /> The quarterly summary report shall be Fubmitted within 15 days of rhe end of each <br /> quarter. <br /> Quarter I - Jaouary --) March <br /> Quarter 2 - Ap r,i I --) �� raj <br /> Quarter 3 - July --) Scptcmhi•rJune <br /> Quarter 4 - October --) Crocember ` <br /> Send to: SAN JOAQUIN LOCAL HEALTIi D1S-1-k1C-1 APR 6 1989 <br /> 1601 E . l:a c 1 t ut , I' . 0 . lice: 2(l(19 ENVIR0N,M'NTAI_HE.ALTH <br /> Stockton , CA 95201 460 -67b1 PERMIT/SERVICES <br /> K;T 40 l0i 8G <br />