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• Wltt CAMLOC i nT -Ole <br /> �.y <br /> i . t.cilic : Yh lD cam i•�Ac.7o/Z 'siselProeocc• boU <br /> s t <br /> • Tear: <br /> Cautin,t Period reventory <br /> A Tariatiom<s <br /> s � a <br /> � Val <br /> Dipstick s E.rceedF.- Prom To P tick Actualovabie Allowableteed og Reading Tuiatioiatioo wariatioa <br /> Fr t <br /> Date/Ti-ve Date/Time hallo Is E>F <br /> Inches Callous aches Callon: Callous /-Gallons Yes/No <br /> ter_ 3 /- <br /> 9,1199 <br /> v /- <br /> .p !- <br /> /- <br /> • Allowable variation s .01 If Total is 0 --)1 S - Eater Exact Amount <br /> Tank size Total — Over S - tater S <br /> •' if you Answered yes in Columb C. S.J.L.H.D. gaviromwatal Kealtb shalt be motified within <br /> 24 "ours and an Unauttlorise.l Release Report Swbsitted withis S days. <br /> SAN JOAQUIN LOCAL KTALTH DISTRICT <br /> UGT 30 10/66 1601 E. liazelton. Stockton. CA 95205 <br /> 466-6781 <br />