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�' • RECENtu <br /> INVENTORY RECONCILIATION APR 4 1991 <br /> QUARTERLY SUMMARY REPORT FORM ENVIRONMENTAL HEALTH <br /> PFRMIT <br /> FaciLitT Name: D. H . WINN TRUCKING INC . Tank Size Product <br /> 17, <br /> Facility.Address: 19555 North Tully Road <br /> P . 0 . BOX 24 . i nL���,�1 <br /> Telephone : 209-727-5531 ���� <br /> Person Filing <br /> Report <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 Columa 13 of the inventory Reconciliation Sheet) <br /> Inventory 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 unauthorised (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank 1, and amount for all variations that exceeded the <br /> allowable licnits. <br /> Date Tank 0 Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. X <br /> S. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> paper .snd attached. <br /> If the source of the variation which. exceeded 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 and an unauthorized release report submitted. <br /> The quarterly summ.7ry report shall be Fubwitted within 15 days of the end of each <br /> quarter. <br /> C.Quarter I January --) _March <br /> Quarter 2 - April --> June <br /> Quarter 3 - July --> September <br /> Quarter 4 - October --> t?ecember <br /> Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 F— Haze 6 t o« , P .O . ItOx 1OO9 <br /> Stockton . CA 95201 466 -6781 <br /> 1►M' 40 10/ 86 <br />