Laserfiche WebLink
QUARTER NO. TWO APRIL-JUNE <br /> V LN I INVLNTORY RLCONCILIATION <br /> SEP 1 2 1891 QUARTERLY SUMMARY REPORT FORM (Mont6v� Cad VACLkVe *-s) <br /> NV I Rr'11011AP I T"�I <br /> Fa c i 'Stb�ck&LT" <br /> Unified School District <br /> Tank # Size <br /> Product <br /> Facility Address : 1932 N. El Pinal Dr. ONE 10,000 Diesel <br /> 1 <br /> TWO 12 ,000 Diesel <br /> Stockton Ca. 9520S THREE 1 0 000 Diesel <br /> Telephone: 944-4078 FOUR %8 ,000 Gasoline <br /> Person Filing <br /> Report:_ Charles Leubner FIVE 12 ,000 Gasoline <br /> I hereby certify under penalty of perjury thatallinventory 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 5-15-91 ONE +110 <br /> 2 . 5-16-91 ONE +138 <br /> 3 . 5-17-91 ONE +162 <br /> 4 . 5-20-91 ONE +200 <br /> 5 . 5-24-91 THREE +140 <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 /> EII 23 019 10/86 <br />