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QUARTERLY INVcN T ORY REPORTINJGA�Y `� ' ';'/ <br /> I <br /> Oct , 1999 <br /> Facility Name: �� ��_ Ste_ I% Tank * Size Prrci H �,_ <br /> Facility Address: � i3 i 1�4�-��o� 4 Z <br /> City: <br /> County:, <br /> State: w <br /> Waste 011 <br /> I hereby certify under penalty of perjury that all product <br /> ❑ level variations for the above mentioned facility were <br /> within allowable limits for this quarter. <br /> Inventory variations exceeded the allowable limits for <br /> this quarter. I hereby certify under penalty of perjury <br /> that the source for the variation was NOT due to an <br /> unauthorized (leak) release. <br /> List date. tank # and amount for all variations <br /> that exceed the allowable limits <br /> Date Tank Amaunt Date Tank A� Amount <br /> 7- <br /> -7-/d c <br /> "7_7_ 1 . -21-- 512- <br /> - - Z -�7 <br /> 7-3 9 ! t S <br /> -��� / t 77 3 - 7 Sig <br /> / 77 <br /> The quarterly summary report shall be submitted within 15 days <br /> of the end of each quarter. <br /> Quarter i - January thru March Submit by April 15 <br /> Quarter 2 - April thru June Submit by July 15 <br /> Quarter 3 - July thru September Submit by October 15 <br /> Quarter 4 - October thru December - Submit by Janaury 15 <br /> Send To (Local Agency) : - Sc' N <br /> r <br /> S <br /> C'- 'e cr.=� S. <br /> KEEP COPIES OF THIS FORM FOR YOUR OWN RECORDS <br /> DATE MAILED 9 <br />