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SAN JOA(IrTIN COUNTY PUBLIC HEALTH SF2VICES V <br /> *RONMENTAL HEALTH DIVISI PMYTr-'� <br /> ANNUAL INVENTORY RECONCILIATION SUMMARY REPORI�,, <br /> California UST Regulations, Article 4, Section 26 4 . <br /> _ 1995 <br /> Facil,- ty Name N'� EWIDWNTAL <br /> PE ITISEPI"CIT111TH <br /> Address City J <br /> All 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 /> ) h 19 9 'i to -11" ) ') 19 1� /I . <br /> Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK PRODUCT AMOUNT (Gallons) <br /> F <br /> -)o- <br /> 7 9 1-)0 <br /> 1) o 0 <br /> 21 <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 /> 1 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 /> -r P o'-'0 <br /> Facility Tank operator/Owner Date <br /> EH 23 019 8-1-92 <br />