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QUARTER N0. ONE JANUAI MARCH 1991 <br /> r r INVENTORY RECONCILIATION <br /> SEP Z QUARTERLY SUMMARY REPORT FORM 6rAonc6--%ffai-tvAct6a #S� <br /> .J <br /> Facility School Dist . Tank # Size Product <br /> ac �;(�"r T932 N. E1 Pinal Dr . 10 . 000 <br /> Facility Actress : WO 12 000 <br /> toc ton a. THREE 10 000 <br /> Telephone: 944-4 FOUR 8 000 <br /> Person Filing FIVE 12 000 <br /> Report: . Charles Leubner <br /> GASOLTNF <br /> I hereby certify under penalty of perjury that all inventory variations <br /> F1for 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 /> a 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 . 1-31 -91 ONE + 165 <br /> 2 . 2 -06-91 ONE +114 <br /> 3 . 2-07-91 ONE +138 <br /> 4 . 2-19-91 ONE +109 <br /> 5 . 2 -20-91 ONE +146 <br /> Additional dates/amounts shall be continued on a separate sheet <br /> paper and attached. <br /> (_SEE 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 />