Laserfiche WebLink
INYENtORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> i facility Nasse: Port Stockton Food Dist Tank f Size Product <br /> 1 2000 Diese <br /> Facility Address: 1950 E Miner <br /> _Stockton, CA 95205 <br /> Telephone : 209-948-1814 <br /> Person Filing <br /> Report _ Randy Thomas <br /> 0 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 /> ® 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 dater tank to and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank / Amount t " <br /> 1• 8/15/89 1 +32 after fill f " <br /> 2. <br /> 3. PER SCd1CcjLI <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 allowable limits was due to <br /> . leak the incident shall be reported to 5 .J L . H . D . Environmental Ilcalth <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 cacti <br /> quarter. <br /> .x <br /> Quarter 1 - January --) March <br /> Q'Aarter 2 - April --) June <br /> Quarter I - July __) Scptcmb.-r 0 <br /> Q-,arter 4 - October --> Ikrcembcr 1• <br /> Send to: SAN JOAQUIN LOCAL liEAL'1'1i DISTRICT <br /> 1601 E . Haz(- 114111 . P . I) It 7110'1 <br /> Stockton . CA '0201 /•l.I, - fr1b <br /> th;'p 40 I0/ A6 <br />