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INVENTORY RECONCILIATION 0 CT 0 3 NM <br />QUARTERLY SUMMARY REPORT FORM <br />Facility Name: D. H. WINN TRUCKING , INC. <br />Facility,'Address: 19555 North Tully Road <br />. <br />P. O. BOX 24 ,,E n�for <br />Telephone: 209-727-5531 <br />Person F)h y <br />in <br />Report G�� � <br />—Z <br />Tank f Sizc Product <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 Coluaus 13 of the Inventory Reconciliation Sheet) <br />Elinventory variations exceeded the allowable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />was cot due to an unauthorized (leak) release. (Yes in Column 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank f, and amount for 211 variations that exceeded the <br />allowable limits. <br />Date <br />1. <br />3. <br />4. <br />S. <br />Tank f Amount <br />Additional dates/amounts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which.exceeded al,lowabLe limits was due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental Health <br />within 24 hours and an unauthorized release report submitted. <br />The- quarterly summary report shall be ,submitted within 15 days of the end of each <br />quarter. <br />Quarter I - January --> March <br />Q,Aarter 2 -- April --> June <br />Quarter 3 - u y eptcmhe:r� <br />Quarter 4 - Qetobcr - Deccmbcr <br />Send to: SAN JOAQUIN LOCAL HE:ALT'}i DISTRICT <br />L601 }:. lIaT_C E l Ian . P .0 . ho x 2()()9 <br />Stockeon. (:A 95201 466-67bl <br />1J(;"I` 40 10/80 <br />