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' i-04EIV <br /> •INVENTORY RECONCILIATTtl Ei <br /> ' <br /> QUARTERLY SUMMARY REPORT FO <br /> Q 9AN 13 1992 <br /> Facility Name: PAUL'S UNOCAL 76 TankE VIRONMENT ��A'.. �I � product <br /> • 6et E. , a 0 EX <br /> Facility Address:Lodi, CA 95240 Ph. 363-0715 z z ,. <br /> ARL). No. ATG97T6T— <br /> Telephone: ; Z4 z <br /> Person Filing <br /> Report: <br /> I hereby certify under penalty of perjury that all inventory <br /> variations for the above mentioned facility were within the �J <br /> all able limits for this quarter. (No in column 13 of the / <br /> .� I entory Reconciliation Sheet. )___., <br /> Inventory variations exceeded the allowable limits for this <br /> quarter. I hereby certify under penalty of perjury that the <br /> source for the variation was not due to authorized (leak) <br /> + release. (Yes in Column 13 of the Inventory Reconciliation <br /> Sheet) . <br /> List date, tank #, amount for all variations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank Amount Reason <br /> 1. <br /> 2. <br /> 3 . <br /> 4 . <br /> 5. <br /> Additional dates/amounts shall be continued on a separate <br /> .sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted: <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> Quarter 2 - April ----------->June <br /> Quarter 3 - July ------------>September <br /> Quarter 4 - October <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />