Laserfiche WebLink
INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: D . N . WINN TRUCKING , INC . rank I Size Product <br /> Go ,77 7 E s 771 <br /> FaciiityAdd�ress: 19555 North Tully Road u <br /> R . 0 . QQX 24 <br /> Tele hone :. 209-727-5531 <br /> Pers n i <br /> Repo C Olt P(dllz <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 Column 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 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 /> Date Tank E Amount '141 � <br /> 3. (1;�'', h'r <br /> E3 <br /> 4. <br /> 5. <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 a1'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 E - Jaaunry --) March <br /> Q+ssrter x - April --> Julie <br /> Quarter 3 - Jul --> �cptcmhcr <br /> rtcr 4 - October --> C}ecrmber <br /> Send to: SAN JOAQUIN LOCAL HEALI-H DISTRICT <br /> 1601 E . Haze l i ()" , P .O . 1�()v 2()()9 <br /> Stockton , CA 95201 466-6781 <br /> Lici, 40 10/ 86 <br />