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SAN JOAN COUNTY PUBLIC HEALTH SI*CES <br /> EP. RONMENTAL HEALTH DIVISION <br /> ANNUAL INVENTORY RECONCILIATION SUMMARY REPORT <br /> California UST Regulations, Article 4, Section 2646 (j) <br /> 3RESHEARS CHEVRON #3-388 <br /> PHONE: 62;J'-'7, 17 <br /> Facility Name 924 EAST YOS,,_, :1 <br /> CALIFORNIA 953`36 <br /> Address City <br /> alAll inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Regulations, <br /> Division 3 , Chapter 16, Section 2646, for the 12 month period from <br /> 19 to 19 <br /> ❑ Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK # / PRODUCT AMOUNT (Gallons) <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 JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 2009 <br /> STOCKTON, CA 95201 <br /> I certify under penalty of perjury, that all variations (if any) <br /> exceeding allowable limits are indicated above (California Health & <br /> Safety Code, Section 25299) : <br /> Facility Tank Operator/Owner Date <br /> EH 23 019 8-1-92 <br />