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If SA.v j'OAQU_N COL-NT'� PUBLIC HEALTH SERVICES <br /> ENV" 1NMr.."NTA.L HEALTH DIVISION <br /> ANNUAL INVr....%4TORY RECONCILIATION SUMMARY REPORT <br /> California UST Regulations, Article 4, Section 2546 (j) <br /> Facility Name f)/n��/)') #�W& <br /> Address .� /� /�� CCS/�7Dl�niQ , City 'S/Oc% 7�C <br /> FZAll inventory variations for the above mentioned facility wers, <br /> Within allowable limits of Title 23 , California Code of Regulations, <br /> Division 3 , Chapter 16, Section 2646, for the 12 month period`.-€ram' <br /> Q CCl�?fjf Y / 19 93 to 19 9-3 <br /> Inventory variations in excess of the allowable limits of Section-- <br /> 2640' occurred as listed below. .. <br /> DATE TANK / PRODUCT AMOUNT (Gallons) <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 /> ENVIRONXZNTAL HEALTH DIVISION <br /> P.O. BOX 2009 <br /> STOCXTONt CA 95201 <br /> I 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 /> acility Tank Operator/Owner Date <br /> EH 23 019 8-1-92 <br />