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,I <br />Y �x <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM <br />Facility Name: <br />Facilsty 4ddress: 1301 West Kettleman <br />Lodi, Call?. <br />Telephone ��©91 ,3q_3233 <br />Person Filing <br />Report Pete Graffigna <br />I hereby certify under penalty of perjury that all inventory variations For <br />the above mentioned facility were .within the allowab.le:timits for this <br />carter. <br />q (moo in Column 13of Reconciliation Sheen <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 />vas not due to so unauthorised (leak) release. (Yes in Column 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank i® and amount for all variations that exceeded the, <br />allowable limits. <br />Date Tank ! Mount <br />1 • Deg 8.7 1 0 <br />2. Dec 87 2 0 <br />3. Dec- 87 3 0 <br />4, <br />S. <br />Additional dates/amouats shall be continued on a separate sheet of <br />paper and attached. <br />It the source of the variation which. exceeded al'towabte limits was due to <br />a leak the incident shall be reported to S.J.L.H.D• Environmental Hcalth <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be submitted within IS days of the end of each <br />quarter. <br />Quarter 1 January --> March <br />Qlarter 2 - April .lune <br />Quarter 3 July > September <br />Quarter 4 - October -> December <br />JAN 6 1988 <br />Send to: SAN JOAQUIN LOCAL-HEAL1'Ii >UIS'1'ttlC'1' - <br />1601 L. Iiaze 1 L oll . P.O. Box 2009 BAN JOAQUIN <br />Brockton, CA 9520I 466.-6761 AIR <br />POLLUTION CONTROL DISTRICT <br />tJCT 40 10/86 <br />