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f j SAN JOAQ COUNTY PUBLIC HEALTH SERVICES <br />EN71 Oi�TMENTAL HEALTH DIVISION <br />ANNUAL INVENTORY ?�ECONCILIA'Y`ION SetionREPORT <br />�646 {� 1 <br />California UST Regulations, Article 4, [r <br />Facility <br />Address <br />✓ All inventory variations for the above mentioned fac!11'Z-y were <br />within allowable limits of Title 23, California C Code ofp e ula ions <br />Division 3,hap ter 16 Section 2646, for the <br />12 i 19 - to <br />Inventory variations in excess of the allowable limits of Section <br />2646, occurred as listed below. <br />Submit report within 15 daytheoog the <br />to bethe <br />submittedmonth <br />toaf the <br />12 --month period covered byreport. <br />SAN O'OAQUIN CouNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 2409 <br />STOCKTON, CA .95201 <br />I certify under penalty of perjury, that all variations (if any) <br />exceeding allowable limits are indicated above (California Health & <br />Safety Goo , ect�i�on 2ry52y9�yr9n') ::AW <br />Facility Tank operatot/Owner <br />EH` 23 019 8-1-92 , <br />v <br />y <br />Date <br />