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SAN JOAQUIN <br /> r COUNTYPLICH LTH SERVICES <br /> RAILTRONMENTAL HEALTH <br /> TH <br /> D1YiSIO <br /> 0 <br /> f � <br /> ANNUAL INVENTORY RECONCILIATION SUMKARY REPORT <br /> 4 alifornia UST Regulations, Article 4, Section 2 6 (j) <br /> IS , r <br /> Facility Name <br /> f,1s <br /> Jq <br /> Address t , <br /> ❑ All inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23 , California Code of Regulations, <br /> Divisio 3 , Chapter 16, Section 2946, for the 12 month period from <br /> ?9 to 19 <br /> Inventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK P / PRODUCT AMO (Gallons) <br /> Submit report within 15 days following the end of the last month of the <br /> 12-month period covered by the report. Report to be submitted to: <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONKENTAL HEALTH DMSION <br /> P.O. BOX 2009 <br /> STOCXTON, CA 95201 <br /> I certify under penalty of perjury, that all variations (if any). <br /> exceedi allowable limit are indicated above (California Health & <br /> Safet Co , Se <br /> I 1 .1 11710 <br /> Facil y Tank Operator/Owner Dat <br /> EH 23 019 8-1-92 <br />