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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> FaciLi.tY Kase: Marton Paint Company Tank <br /> Sive Product <br /> Facilitr,'Address: 38 W. Sonora Street <br /> -Stgckton, CA 95203 j <br /> Telephone ; _ ( 209 )456-4541 <br /> Person F i g - <br /> Report _ 1� VE Lr t r. <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 /> QInventory variations exceeded the allowable Limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> eras not due to an unauthorized (leak) cele:se. (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 f Amount <br /> 3. <br /> 4. ,s 1-tEp,LT1� <br /> EPE9MF1 l SERV 4CES <br /> S. <br /> Additional d2_esl2mouat4 shall be cOntiuued ou a separate sheet of <br /> paper and attached. <br /> If the source of the variation whichexceeded allowable limits was due to <br /> a leak the incident shall be reported to <br /> S .J . I... H . D. Environmental Hcalzh <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly sumczary report shall be submitted within 15 days of the end of each <br /> quarter_ <br /> Quarter I - January --> March <br /> e 2 - April --> Jure <br /> arter 3 - July --> September <br /> Quarter 4 - octobcr --) IAc-ccmbcr <br /> Send co: SAN JOAQUIN 1.()CAL HEALTH UISTK1CI' <br /> 1601 E . Haze 1 t (,,1 1' . 0 _ 1i()N 2()()c) <br /> 1..T 140 10/ H6 Stockton , CA 95201 460 -67bl <br />