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r $a <br /> ° SAN JOWIN COUNTY PUBLIC HEALTH A&VICES <br /> ENVIRONMENTAL HEALTH DIVISIO <br /> L INVENTORY RECONCILIATION SUMMARY REPORT <br /> Cale ° UST Regulations, Article 4, Section 2646 (j) <br /> Facility Name <br /> Address City <br /> All inventory variations for the above mentioned facility were <br /> within allowable limits of Title 23, California Code of Regulations, <br /> Division 3, Chapter 16, Section 2646, for the 12 month period from <br /> 19 to 19 <br /> DQInventory variations in excess of the allowable limits of Section <br /> 2646, occurred as listed below. <br /> DATE TANK # / PRODUCT AMOUNT (Gallons) <br /> - Z 5 t-- LF <br /> S= i9 <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 JOA.QUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> P.O. BOX 388 <br /> STOCKTON, CA 95201-0388 <br /> I cert' y under penal of perjury, that all variations (if any) <br /> exuding llowab e 1 its are indicated above (California Health & <br /> Sa y e, Sec n 299) : <br /> t <br /> L <br /> Faci y Tank O erator/Owner Date <br /> EH 23 019 8-1-92 <br />