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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Faculty Names Tank f Sue I Product <br /> Facility•Addressi q34 Y. Z&- o� { *' <br /> Telephone : i6o9) 3311 - 39,17 ' u`6 <br /> Person Filing 1� ' <br /> Report d+zar f <br /> 0 1 hereby certify wader penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> Quarter. (No in columm 13 of the Inventory Reconciliation Sheet) <br /> 0-1�xnveotocy 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) reLeinse. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) _.�e,,.,�e �.p�; <br />