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pa <br /> 9 <br /> * R a <br /> INVENTORY RECONCILIATION <br /> ANNUAL SUMMARY REPORT FORM MAR 2 5 1993 <br /> ENVIRONMENTAL HEALTH <br /> Year: lQQz. Tank # Size Product <br /> Facility Name: aEAcctJ (-tKDLOGK IUOOO UNLi�-.ADED <br /> Address: '5300 WATFkL(JU ROAD � Ib)Db U1k)LEA D-1- <br /> sTcr-mi'JICA Q6305 3E <br /> 1U o0 -DiES L <br /> I hereby certify under penalty of perjury that: <br /> All inventory reconciliation data for this year was within the allowable <br /> variations (No entered at bottom of all Inventory Reconciliation Sheets) . <br /> r-7S Inventory reconciliation data for this year was not within the allowable <br /> Iii variations for the months listed below (Yes entered at bottom of Inventory <br /> Reconciliation Sheets) . <br /> List below the tank(s) and the amount(s) for each month that the allowable variation was <br /> exceeded. To determine the amount exceeded, subtract the calculated Allowable Variation <br /> from the Actual Variation on the monthly Inventory Reconciliation Sheet. <br /> MONTH TANK # AMOUNT TANK # AMOUNT TANK # AMOUNT TANK # AMOUNT <br /> January . ' <br /> February I z45,gc� <br /> March <br /> April <br /> May <br /> June <br /> July IG5 <br /> August <br /> September <br /> October 2 17 <br /> November <br /> December <br /> t oriz d 'Signature Date Title <br /> Submit report within 15 days following the end of each calendar year. <br /> Send To: <br /> &OLMAT109 R* Pe6e(,tA121 ✓Ae1ATlb&/'. Al- THAT Tlblt- WE D�Dn)'T NOT PAVE A <br /> 6rAS804 1A)T6kFAC6 WITH THE TLSZSD• WHEN WE, 'R&c161Jt"D THE /A)r0eMA'nOnJ <br /> F—P-OM THE LOCA r16 X)71f E ?"I 04 6-1 J06-LJ�s 01c 'Tfl F tJE iC T M pu To f V£A— Ld 6 4cJEeC <br /> I,WITRW PLIbuJP,"8L.0 ANoLwTS. SIS T06 )1)T&eCACE WE; " L0K)&jF , #VAUIE- O�A- <br /> Tia-tr=W - Pe06L6 t- <br />