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SAN joAQumL COUNTY PUBLIC Hr.ALTa S�:RVTCZS <br />NMENTAL HF-XLTH D=SIOx 0 <br />ANNUAL INVENTORY RECGNCIL1XTION SUMMARY REPOR`t <br />California UST Regulations, Article 4, Section 264&tYl°"' .LliL-41 T1, <br />r, y X11, <br />Vt 12:1{ <br />Facility Name colfIC\- c\� 42 <br />Address �,•D-ac-Ld City ca <br />All inventory variations for the above mentioned facility were <br />within allowable limits of Title 23, California Code of ReguL-4_ti.ons, <br />Division 3, Chapter 16, Section 2k46, for the 12 moth period from <br />N1 1962 j to �f' 3 \ 29_ a _ <br />Inventory variations in excess of the allowable limits of Section <br />2646, occurred as listed below. <br />Submit report within 15 daysfollowing the end of the, last month of the <br />12 -month period covered by thereport. Report to be submitted to: <br />ENVIROMCMAL EMALTH DIVISION <br />P.O.BOX 2009 <br />STOCXTOHi•A • <br />I certify under penalty of perjury, that all variations (if any) <br />exceeding allowable limits are indicated above (California Health & <br />Safety Code, Section 25299): <br />Facility Tank operator/Owner <br />EH 23 019 B-1-92 <br />Date <br />