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I. <br />NPW <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Facility Name:DEUEL VOCATIONAL INSTITUT <br />Facility Address:23500 KASSON RD. <br />TRACY, CA. 95376 <br />Telephone: 209-835-4141 EX. -4220 <br />Person Filing <br />Report: G.B. GILLIAM E.M.S. <br />I hereby certify under penalty of perjury that all inventory <br />variations for the above mentioned facility were within the <br />allowable limits for this quarter. (No in column 13 of the <br />Inventory Reconciliation Sheet.) <br />Inventory variations exceeded the allowable limits for this <br />quarter. I hereby certify cinder penalty of perjury that the <br />source for the variation was not due to authorized (leak) <br />release. (Yes in Column 13 of the Inventory Reconciliation <br />Sheet). <br />List date, tank 1, amount for all variations and the reason <br />for exceeding the allowable limits. <br />Date Tank Amount Reason <br />1. NONE NONE NONE NONE <br />2. <br />3. <br />4. <br />5. <br />Additional dates/amounts shall be continued on a separate <br />sheet of paper and attached. <br />If the source of the variation which exceeded allowable limits <br />was due to a leak, the incident shall be reported to Public <br />Health Services of San Joaquin County Environmental Health <br />Division, within twenty-four (24) hours and an unauthorized <br />release report submitted. <br />The quarterly summary report shall be submitted within fifteen (15) days of <br />the end of each quarter. Circle appropriate quarter. <br />Quarter 1 - January ---------- >March �aNy. <br />Quarter 2 - April----------->June66 <br />Quarter 3 - July------------>Septem � <br />Quarter 4 - October --------->December OCT 0 9 1991 <br />Send to: SAN JOAQUIN 'PUBLIC HEALTH SERPUMNNIENT.AL HEALTH <br />ENVIRONMENTAL HEALTH DIVISION Pt7RN1IT,/SERVICES <br />1601 E. Hazelton Ave.,.P.O. Box 20'69 <br />Stockton, CA 95201 <br />(209) 468-3420 <br />