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i <br /> i <br /> } loci 1 it :W2 D CSL <br /> TT Tank#:• �Sise/Product: ( 000D Tears <br /> Causing Period Inventory Variations <br /> A a - C D E r C <br /> imam"& Exceed <br /> Dipstick Dipstick Actual Allowable Allowable <br /> FCO° To Reading leading Variation Variation Variation <br /> (C-D) Is E>F <br /> Datc/Ti-oe Date/Time Inches Gallons nchest Callons Cellons /-Zallons Yes/No { <br /> 4. 0 O /- <br /> /- <br /> /- <br /> • Allowable Variation x .QI If Total is 0 --> 5 - Enter Exact Amount <br /> Tank stse Total Over 5 - Enter 5 <br /> •" if you paswered yes in Column C, S.J.L.H.D. Environmental Health shall be notified within <br /> 24 Hours and an Unauthorixe.l Release Report Submitted within 5 days. <br /> SAN JOAQUIN LOCAL K ALTH DISTRICT <br /> UGr 38 10/66 1601 E. hazelton. Stockton. CA 95205 <br /> 466-6781 <br />