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0 <br />INVENTORY RECONCILIATION <br />94AR+[-Rf~Y SUMMARY <br />���� <br />Facility Name: D. H. WINN TRUCKING , <br />REPORT FORM <br />INC. <br />PacilityWdress: 19555 North Tully Road <br />P. BOX 24 <br />Telephone: 209-727-5531 9b' 131 <br />Person Filing _ <br />c)b'��24. 'fri'x <br />1 D <br />JAIL 04 ISD <br />ENVIR Nile ENTAL HEA! ..Th <br />Pc RMIT,' ,'E -RVI 1C E -S <br />Tank 0 Size Product <br />12/ 1 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 />was not due to an unauthorized (leak) release. (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 />4. <br />5. <br />Additiocal dates/=mounts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which.erceeded allowable limits was due to <br />a leak the incident shall be reported to S . J . L.H.D. Environmental Health <br />within 24 hours aad an unauthorized release report submitted. <br />b (lnc)z <br />the end of each <br />The �}iy summary report shall be submitted within 15 days of <br />qusrecr_ ��` <br />Quarter i - January --} March <br />Q+sarrcr 2 - Apra l --> June <br />Quarter 3 - July --} septca,hcr <br />ar[cr 4 - Octobcr --) December <br />Send to: SAN JOAQUIN 1,0CAL HEAL1'li DISTRICT <br />1601 K. HaZC 1 t "1) , l' .0. 1�()Y "2_()()`) <br />SCockr-on. (:A 95201 466--67b1 <br />(;T 40 10/86 <br />