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INVENTORY RECONCILIATION <br />QUAI: SUMMARY <br />♦..: 6ist.1 FO <br />1 <br />Facility Names Flame, Liquors Inc <br />Facility Address: 1301 W. Kett eninLane <br />' ...Ledi, gali.fornia <br />Telephone: 209 368-6633 <br />Person Filing <br />Report pAt-P rrafficma <br />JAN 51989 <br />ENVIRONMENTAL HEALTH <br />PERMIT / SERVICES <br />MIT= <br />I hereby certify under penalty of perjury that all inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />quarter. (No is Columa 13 of the Inventory tRecobciliation Sheet) <br />El Inventory variations exceeded the allowable limits for this quarter. I <br />bereby 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 &mouat for all variations that exceeded the <br />allowable limits. <br />Date Tank E Amount <br />1. c �x <br />2. DJC Y <br />3. 3 <br />4. <br />S. <br />Additional dates/amounts shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the variation which. exceeded al'lowabte limits was due to <br />a leak the incident shall be reported to S.J.L.H.D. Environmental HCaith <br />within 24 hours aad 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 - January --> March <br />Quarter 2 - April -> June <br />Quarter 3 - July --> September <br />Quarter 4 - October --> December <br />Send to: SAN JOAQUIN LOCAL HEALTH UI5'1'KIC'1' <br />_ 1601 K. flare l tun r P.O. BOX 2009 <br />Stockton, CA 95201 466-61bl <br />LILT 40 10/86 <br />