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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Naas: ��. 'T-15-5 r � � Tank I <br /> Size Product <br /> Facility /lddresa. 7 p � ` .. r/l' <br /> L t. <br /> Telephone : <br /> Person Filin, <br /> Report -�,�, -� <br /> L hereby certify under penalty of perjury Chat all inventory variations for <br /> the terve (No ioncd facil"T were within the Allowable limits for this <br /> quarter. (No in COW..a 13of the laventory Reconciliation Sheet) <br /> ❑ Inventory variations exceeded the allowable limits for this quarter_ <br /> hereby certify under penalty of I perjury that the source for the variation <br /> vas not due to an unauthorized (leak) rcicaae. (Yes i4 Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank I, aad :mount for all variations that exceeded the <br /> allowable liai[A. <br /> Date Taak I Axaouac <br /> 1, <br /> 2- <br /> 3- <br /> _3. <br /> 4. <br /> 5. <br /> Adddaces/amouatt cha p be continued on a separate sheet of <br /> PaPcr and attached, <br /> i <br /> if the source of Chc vaciaci,on which rxc+!cded allowable limits vas due to <br /> a leak Chc incident shall be rcl,or(ed to <br /> Kithin 24 hours and an unauthorised release report ©bmEC[eti <br /> donCal klCalClr <br /> Thc quarterly su--ry re-PGrC shall br xubmi <br /> quarter_ [[cd within IS drys of the end of c.zch <br /> 0 a r January <br /> QsJsr(,tr 1 - AprI I <br /> Qt•arc,. - Jul <br /> Y --> lclrtcmhrr <br /> aartcr 4_ - Glctob��r __) <br /> 11+tCrmh�r 1`� <br /> i <br /> Send ca: SAN JOAQUIN I,( CAI, HEA1.1'Ci !)I1�'1'Il1C'1' <br /> 1 60 l 1: . I',�zc 1 r rrrl , 1'' . O . Sox <br /> ��0 10/80 'Lo ckton . CA 95201 1466 -G ]bi <br /> ' <br />