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.. INVENTORY REGONCILIATION. <br /> QUARTERLY SUMMARY.. RFPORT FORM <br /> FAcility• Name. �, Produc[ ` <br /> ���_ -��C-2� '>iVU � r� /� �GTank. P' . •Size i . <br /> /` O <br /> 77 <br /> Facility Addreas• <br /> 'Tf 2.X4,o <br /> Telephone : <br /> Pdrson Filing,," ; <br /> Rep9rt <br /> l L hereby eereify under penalty of perjury' rhat 'a11 inventory vcr-..z:Cioasry for <br /> / 1 the above -mcncioned facility were Within Che alLovable Limiti for this <br /> qurctcr. (No in CoLusas 13of the inventory Recanciliation Sheet) <br /> Inventory. variations exceeded the allowable_limits for thii,v41!rter. <br /> hereby cerCify under penalty of perjury ,ihfo <br /> at Che source r the variation <br /> van aor'$ue Co an unauthorised (leak), releiac3:' (Ye19 <br /> ' in Column 13 of the " <br /> Luvcacory koconciliition 'Shee[) <br /> List 0, and xnou'n[°for all vaciatiooa chat-exceeded the - - <br /> •allowabtc lytaitCa. - - ` <br /> . -DiEe Tank ,f Ab�oua6 •. ¢ /�/�' <br /> �✓O`� f/j <br /> s v 0 oFtiM X1990• . . <br /> 5 /CiFq�j� <br /> Additioaal, daces/amounts chall be continued on x separate aheet o,f <br /> paper and acLached <br /> .. Ff Che ,a ou Lof [he va r.ia[ ton Jhish esceed'ed al'Iovable l'imics was. due to <br /> • a leek°Che incident shall.-be reported co S .J... I.. H . D . Environmental flcaLCh ' <br /> Within 24- hours and an unj*uthoriz.�d celcise .rcpor•t -submitCed. <br /> Ilse QuarEcrly su--.Cy r,porC: sisalC be aubmi E[Cd within 15 days, of "'01C end of cdf:11 <br /> •Janu.ry --> .Harsh . . <br /> .Qua c C c r•'2. April --) June <br /> Quarter 3 - July <br /> ' l Qusrtct 4 october, -+> 'lk Cc•mh C•r - <br /> Send co: SANJOAQUI.N LOCAL HtALTli U1.S•I'RICT <br /> 1691 E . Hazelitin , P .O . Hoo 2009 • <br /> Stockton . CA 95.201 ` 460-67b1 <br /> 'I• 4p, •1'O1 tib <br />