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INVENTORY 1 <br />QUARTERLY REPORTit <br />Telephones <br />Person FLI, <br />Report <br />I hereby certify under penalty of perjury that all inventory variations for <br />the above mentioned facility veto within the allowable limits for this <br />quarter. (No in Colums 13 of the Inventory Reconciliation Sheet) <br />Inventory variations exceeded the allowable limits for this quarter. t <br />hereby certify under penalty -of perjury that the source for the variation <br />was not due to An unauthorized (leak) release. (Yes in Column 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank i® and ammac for all variations that exceeded the <br />allowable limits. <br />Date Tank 0 Amount <br />1. <br />2. <br />3. <br />4. <br />5. <br />Additional dates/amoucts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which. exceeded at-lowable limits was due to <br />a leak the incident shall be reported to S.J.L.H.D. Eavironmentat !Health <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be submitted within 15 days of the end of each <br />quarter. <br />Quarter 1 Jaauary --> March <br />Qiarter 2 - April --% June n <br />Quarter 1 - July --> September If <br />Quarter 4 - October --> December It . <br />Send to: SAN JOAQUIN LOCAL HEAL1'li DIS-1.14ICT <br />1601 E. l:aze l t t®ii • P.O. BOX 2009 <br />• Stockton, CA 95201 466-6761 <br />.1t;T 40 10/86 <br />