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s=$r.: - 4`, ' a''•<a ?iws 7 <br />77, MY <br />INVENTORY RECONCILIATION <br />s <br />QUARTERLY SUM; RY REPORT FORK <br />Faci:iry N Fl.'ameLiquors Inc e�tk � ; visa Product <br />Re g <br />lacil tyWdresss 1301 W. Kettl4manLane ire <br />Telephone �R.. <br />Person Filing <br />ReportRato <br />ina g <br />L hereby ccctrfy under penalty of perjury.that--a11' inventory variations for <br />the above mentioned facility were .vithic, ;be allable limitc for this <br />quarter, (leo in Column 13of:tlae Sheet) { <br />El Inventory variations exceeded the allowable .liwita for this quarter. T, <br />hereby certify under penalty fq_perlury t "t two soutte for the veriatian :a <br />v s not due to leo unauthorised (X*4I release. (Teo is Colusa 13 of the <br />Inventory Reconciliation Sheet) <br />t <br />List dat+s, tank Or and t for-al! vacietions,that exceeded the <br />allowable limits. <br />Date 'yank Axm�unt <br />1. k�U. 'RECEIVED A <br />2 ° e of <br />.g, ._ I f , <br />4. PERMIT/SERVICES <br />dit oral date s /a L Zkoucts shall be continued on a separate sheet of <br />paper and attached. <br />It the source of the variation which.exceeded at-towable Limitswas due to <br />a leak the incident shall be reported to S'.J.L.H.D. ovironmental licalth <br />within 24 hours and an unauthorised release report submitted. <br />The quarterly summary report shall be submitted within 15 days. of the end of each <br />quarter. <br />Quarter 1 January ---> March <br />Quarter 2 April, June <br />Quarter I - July --? September <br />Quarter 4 - October December <br />Seed to: SAN JOAQUIN LOCAL, HEALI'11 DISTKIC°1' <br />1601 K. llareltml, P,O. ISOX 2009 <br />Stockton`, CA 95201 466-6161 <br />0(L 40 10/86 <br />