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INVENTORY RECONCILIATION LNvjjtU.`1,--:'jTAL <br /> LTH <br /> QUARTERLY SUMMARY REPORT FORM FERI✓III/SERViCES <br /> Facility Name: Yank I Size Product <br /> 824 EAST ' ! >, -e <br /> Facility Addre'imWN-1 _ — 3 IX L;;-AP <br /> Telephone : Y�'Z- 3- <br /> Person Filing, <br /> Report �acl.�P �>Lt�d-/ <br /> FTI--�, 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 13of 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 unauthorized (leak) release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank 1, and amount for 211 variations that exceeded the <br /> allowable limits. <br /> Date Yank rF Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> S. <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 al-lovable limits was due to <br /> a len4 the incident shall be reported to j 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 I - January --) March <br /> Qiarter 2 - April --) June <br /> Quarter 3 - July __) septembcr <br /> Q4,arter 4 - October --) December <br /> Send to: SnN .lOnQl1IN LOc:nl, HEALIH U1.'i'II( 1(:1' <br /> 1601 F . Haze11 (m , P . 0 11,)x 21111'1 <br /> Stockton , CA (0201 661) -67bl <br /> U1,'I' 1,O 10/ 86 <br />