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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM CmOn;6-,n� C&vA ke (�s) <br /> Facility Name: Transportation - S Tank # Size J Product <br /> 110 .000 sel <br /> Facility Address:2 63 San uinetti Lane 2 V 12 ,000 Diesel <br /> Stockton Ca. 9520 3 L 10 ,000 Diesel <br /> Telephond: 944-4734 <br /> Person filingJay Zimmerman <br /> Report: Director Trans ortation <br /> I hereby certify under penalty of perjury that all inventory variations <br /> for the above mentioned facility were within the' allowable limits for <br /> this quarter. (No in Column 13 of the Inventory Reconciliation Sheet. ) <br /> Inventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the varia- <br /> tion was not due to unauthorized ( leak) release. (Yes in Column 13 of <br /> the Inventory Reconciliation Sheet) . <br /> List- date, tank # , and amount for all variations that exceeded <br /> the allowable limits. <br /> Date Tank # Amount <br /> 1 - Jan . 16- 1 990 1 + o4 <br /> 2 • Jan . 24 . 1990 1 2 . 49 <br /> 3 • March 29 . X990 1 _ 30 <br /> 4 • March 2 . 1990 _� q 94 <br /> 5. <br /> Additional dates/amounts shall be continued on a separate sheet <br /> paper and attached. <br /> If the source of the variation which exceeded allowable limits was <br /> due to a leak, the incident shall be reported to San Joaquin Local <br /> Health District; Environmental Health Division, within twenty-four <br /> (24 ) hours and an unauthorized release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15 ) days <br /> of the end of each quarter. <br /> Quarter 1 - January----------->March <br /> Quarter 2 - April------------>June <br /> Quarter 3 - July------------->September <br /> Quarter 4 - October---------->December <br /> Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton, P.O. Box 2009 <br /> Stockton, CA 95201 468-3420 <br /> 1 <br /> Ell 23 019 10/86 ` <br />