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� I <br /> INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY RF--PORI FORK <br /> rscLLLcr Nmwt '� r G� Tank 1 site Pcodu t <br /> ra.cL4tp_Asan..: 7 9A41//V 6 2- <br /> e 0- <br /> -e0- -7dIV •63,f,:?-412 <br /> Te Lephone: 9 t ;2 <br /> Person Filing <br /> Repore <br /> beceby eeccify wades PCsalty of perjury that all inventory vaciatioos for <br /> Ilse above swecioaed facility were within the allowable limits for this <br /> quactec- (No im Column 13 of the lavencocy Reconciliation Sheed <br /> Qtnvestocr variations exceeded the allowable limits for this quarter. L <br /> beceby Certify vodee penalty of perjury chat the source for the variation <br /> vas not due to ao uaauchoeited (leak) cclease. (Yes in Column 13 of the <br /> Cnveacary XeeooeiLiaeion Sheer) <br /> List date, tank /. mad amounc for all variations Chat exceeded the <br /> allowable Lialice. <br /> Date Tank 1 AMouaC <br /> 1 - <br /> Z. <br /> J. <br /> S. <br /> AddlClonal daces/asouncs shall be Conclaued oo a separaCe sheet of <br /> papec. and sCCachcd. <br /> It the Gaucce O( the Warta( son vl..il. �crrdrd al lu..ahle I (miCa vat dur to <br /> • le4k the inCsden( shall be (r(•.Ir(r.1 knvironaicnCal 1(r11( 11 <br /> vI,Chtn Z(, hours an.l an una..(h.irirrd lete.is.• rrpnr( submicced. <br /> 111C q-ArCerly auaaarr report shall forvt (hin I) dare of (he end u( c.ifh <br /> 7"a r c r r � <br /> lzq� <br /> Q•aacCer 2 - Apri l --� 1.,...• . <br /> Quact<r ) - Julr --) �r�tc�-h.•r <br /> - October --> Ikcrm(•cr <br /> S<nd co: SAN JOAQU I N 1.()(:Al- HEALTI; <br /> 1601(. I:art61( .Nit:.: t' .V Iolao9 <br /> :a.. <br /> Scockcon . (:A • 415201 4(1(1 -67bI <br /> i 4O in/ N(1 <br /> ♦°•� _rr sI <br />