Laserfiche WebLink
CEIVED <br /> INVENTORY RECONcILIATI(,N�JAN 17 1992 <br /> QUARTERLY SUMMARY REP(UNNIRBWENTAL HEALTH <br /> PERMIT/SERVICES <br /> Faci 1 itT 1'ra©c: l <br /> IA (.( Raw <br /> Pac. icy Address: yl� 'i!� S �/� _ <br /> Telephone : <br /> Person E ' ing ----- <br /> Report c s1 ,J��r`C -.� <br /> ElL hereby certify under <br /> the above -entioned facit <br /> litpwerre within y Of ythe aalLowableelim tsvforations for <br /> quarter- (No in Column 13 of the Inventory Reconciliation Sheet) this <br /> Inventory variations exceeded the allowable limits for this quarter. <br /> hereby certify under penalty of perjury that the source for I <br /> was not due to an unauthorized (leak) release. (Yes in Col the variation <br /> Inventory Reconciliation Sheet) 13 of the <br /> List date, tank #, and amount for all <br /> allowable allowable limics. ations Chat exceeded the <br /> Date Tank # Amount <br /> 1. f _3 l +4. <br /> /z? <br /> 2. <br /> 3. <br /> 4- <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> Paper and attached. <br /> Lf the source of the variation which exceeded allowable limits was dui <br /> a leak the incident shall be reported to to <br /> Within 24 hours and an unauthorired r,. S .J . L. H. D. Environmental licalCh <br /> lease report submitted. <br /> The quarterly summary report shall b,r .ubmitted within IS day-'i ,3t the end of <br /> quarf��r , <br /> Quarter I - January --) Harch <br /> QNiartcr 2 - April --> June <br /> (luartcr 3 - July <br /> latter • _ <br /> - •ccmbec i <br /> -.end to: SAN .JOAQUIN LOCAI.. HEALTH DISTRICT <br /> 1601 E. Iiazelton , I' . 0 . Box 2009 <br /> UCT 40 10/86 Stockton . CA 95201 466_6781 <br />