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INYENtORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Facility Name: Port Stockton Food Dist Tank / Size Product <br /> 1 2000 Diesel <br /> Facility Address: 1950 E . Miner a <br /> Stockton, CA 95205 <br /> Telephone : 209-948-1814 <br /> Person Filing <br /> Report Randy Thomas <br /> aI 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 IS 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 die to in unauthorized (leak) releise. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List dater tack Ir and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank / Amount <br /> I. <br /> 2. <br /> 7. <br /> 4. <br /> 5. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> paper and attached. <br /> Lf the source of the variation which exceeded allowable limits was due to <br /> a leak the incident shall be rr or ted to Environmental Ilea I t h J <br /> r S ..1 . I. . H . O . <br /> within 24 hours and an unauthorized release report submitted. <br /> The Quarterly sumoury rtport shall be submitted within 15 days of the end of each . <br /> quarter. <br /> Quarter I - January --) March �� x <br /> Q,iarrcr 2 - April --> Jul,'! rt <br /> t <br /> Quarter I - July __) iepte.mber 0 <br /> Q-1arter 4 - October --> Ikoember 1% <br /> Send to: tiAN ,lOAQIIIN I,0CAI, HEAI,'1'li 1)151fltlt:'I' N <br /> 1001 Ii . Haze IIfill , 1' . t) R. :•: 7110'1 <br /> Stockton . CA 10201 41,l, - 6 /bl <br /> 11 t'I' 110 lo/ )if) <br />