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SAN J JUIN COUNTY PUBLIC HEALTH �FtVTCES <br /> WVIRONMENTAL HEALTH DIVIS <br /> ANNUAL INVENTORY R C N IATION SUMMARY REPORT <br /> California UST Regulations:', Article 4 , Section 2646 (j ) <br /> Facility Name 1 / /f� N1` <br /> Address bWcity <br /> All inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Regulations, <br /> D 'vision 3 , Chapter 16, Section 2646, for the 12 month period from <br /> Jr� r2 19 9`Z to �V,et�',r. j e, 31 192!2 . <br /> Inventory variations in excess of the allowable limits of Section <br /> 2646 , occurred as listed below. <br /> DATE TANK / PRODUCT AMOUNT (Gallons) <br /> I <br /> I <br /> I I <br /> Submit report within 15 days following the end of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JO.AQUIN COUNTY PUBLIC HEALTH SERVICES c , <br /> ENVIRONMENTAL HEALTH �� Vj N <br /> K1 1 , <br /> STOCKTON, CA - <br /> I certify under penalty of perjury, that all variations (if any) <br /> exceeding allowable limits are indicated above (California Health & <br /> Safety de Section 25299) : <br /> Facility Tank Operator/Owner bate <br /> EH 23 019 8-1-92 <br />