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K,100 Wwn.' <br />INVENTORY i <br />JUARTERLY <br />SUMMARY ac,r O r -1 <br />Facility Name: Flame Liquors Inc <br />�� �� ' "' • fir' <br />wdi. Calif ornka <br />Telephone:o- 36A 1 —6611 <br />ReportPerson Filing <br />,- Gj4ffianA <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 Column 13 of the loveotory-Reconeilintion Sheet) <br />Inventory variations exceeded the allowable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />was not due to an unauthorised (leak) release. (Yes is Column 13 of the <br />Inventory Reconciliation Sheet) <br />List dateg tank Or and sawat for &It variations chat exceeded the <br />allowable limits. R999ni. <br />Date Tank Amount <br />ys. <br />fC 16 o <br />I 1 <br />1 <br />Eh ViR,0lNI`v1E-I <br />PEReiMIT / SERVICES LTH <br />Additional dates/amounts shall be continued on a separate sheet of <br />papei .and act'ached. <br />If the source of the variation which -exceeded ahlowabte 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 unauthorised release report submitted. <br />The quarterly summary report shall be submitted within 15 days of the end of each <br />quarter. <br />Quarter I - January --> March <br />QQ,arter 2 - April --i June <br />Quarter 3 - July --> September <br />Quarter 4 October --> December <br />Send to: SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 K. ltaze 1 L oll , P.O. flax 2009 <br />Stockton, CA 95201 466-6761 <br />LJGT 40 10/86 <br />