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ENTORY RECONCILIATION <br /> QWMTERLY S Y REPORT FO,* <br /> Lawrence Livermore <br /> Facility Name: National Laboratory Tank Size ze Product <br /> 879-GlUl 10,000 Gal Regular Gas <br /> Facility Address: P.O. Box 808, L-633 879-G2U1 10,000 Gal Unleaded Gas <br /> Livermore. CA 94550 <br /> Telephone: (415)423-1152. <br /> Person Filing <br /> Report: Wilfred E. Montemayor <br /> I hereby certify under penalty of perjury tha <br /> variations for the above mentioned facility W1 i <br /> allowable limits for this quarter. (No in co IxtPe <br /> Inventory Reconciliation Sheet. ) 199 <br /> Inventory variations exceeded the allowable �P� <br /> quarter. I hereby certify under penalty of pe -fi e <br /> source for the variation was not due to aut o 'zed (leak) <br /> release. (Yes in Column 13 of the Inve ec nciliati n <br /> Sheet) . (To the best of my knowledge) <br /> List date, tank #, amount for1 ariations and the reason <br /> for exceeding the allowable limits. <br /> Date Tank t Amount Reason <br /> 1. (SEE ATTACHED TABLE 1) <br /> 2. <br /> 3 . <br /> 4 . <br /> 5. <br /> Additional dates/amounts shall be continued on a separate <br /> sheet of paper and attached. <br /> If the source of the variation which exceeded allowable limits <br /> was due to a leak, the incident shall be reported to Public <br /> Health Services of San Joaquin County Environmental Health <br /> Division, within twenty-four (24) hours and an unauthorized <br /> release report submitted. <br /> The quarterly summary report shall be submitted within fifteen (15) days of <br /> the end of each quarter. Circle appropriate quarter. <br /> Quarter 1 - January---------->March <br /> ua - pri ----------- e <br /> Quarter 3 - July ------------>September <br /> Quarter 4 - October --------->December <br /> Send to: SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. Hazelton Ave. , P.O. Box 2009 <br /> Stockton, CA 95201 <br /> (209) 468-3420 <br />