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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM '" ti1�► <br /> Facility Name: D _ H . WINN TRUCKING INC . Tank € Size t <br /> Facility Address: 19555 North TuI ly Rodd ~' <br /> LOCKEFORD , CA. 95237 <br /> Telephone : 2{)q_777-�i427 - -- <br /> Person Filing <br /> Report coni Kirkpatrick <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 /> 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 as unauthorized (leak) release. (Yes in Columa13 of the <br /> Inventory Reconciliation Sheet) <br /> List date„ tank 1, and amount for 211 variations that exceeded the <br /> allowable limits. <br /> Date Tank f Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> s. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> p2per and 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 . p, 'Environmental Health <br /> within 24 hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be Fubmitted vithin IS days of the end of each <br /> quarter_ <br /> Quarter I - January --a Harch <br /> Qlarter 2 - April --> June <br /> Quarter 3 - July --> septemher <br /> Quarter 4 -- October --> December <br /> Send to: SAN JOAQUIN 1,0CA1, HEALTH DISTRICT <br /> 160 1 F' . Haze l t -n l' .0 . Eley t()" <br /> St-ocktorn . CA 95201 466 - 67b1 <br /> IICT 40 10/ 86 <br />