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INVENTORY ! f <br />REPORTQUARTERLY SUMMARY O, <br />IF&ciLLty Nam: = r u 1 <br />1E/O C <br />Person <br />Report <br />gi <br />rc�rr/1%�►•! <br />�l�i� /��ljliJ.Mj�l <br />L hereby certify under penalty of perjury that all inventory variations for <br />the above ■entioned facility were within the allowable Limits for this <br />quarter. (No in Column 13 of the Inventory Reconciliation Sheet) <br />Lnveatory variations exceeded the allowable limits for this quarter. I <br />reby certify under penalty. of perjury that the source for the variation <br />was Got due to in unauthorized (leak) releise. (Yes in Col 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank /® and ammut for all variations that exceeded the <br />allowable limits. <br />Date Tank E Amount <br />1. <br />2. <br />3. <br />4. <br />S. <br />Additional dates/amou0ts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which. exceeded allowable limits was due to <br />a leak the incident shall be reported to S . J . L . N . D . Environmental 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 �Jaouary --> March �` `0 <br />Quarter 2 - April --) June <br />Quarter 7 - July --> September <br />Quarter 4 - October --> (kcrmber <br />Send to: SAN JOAQUIN LOCA1. NEA1.1'1i DISTRICT <br />1601 E. liaze 11 on ° P.O. Rom 2009 <br />Stockton. CA 95201 466-67b1 <br />.)C1' 40 10/86 <br />