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i e <br /> INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> E•cllity Ka.Q= �'�—,�i- U � >� Tast Scce <br /> Product <br /> Telephone: 9/j Qj_j d zl/ , D <br /> Person Filin <br /> Report <br /> �rG� D.iI.�.S'vG l�il1r <br /> ❑ E hereby certify vadcc peaslty of perjury that all inventory variation■ for <br /> t6e above oeotioaed facility were within the allowable Limits for this <br /> 4tu4eteea (He is Coluan I3of the laveacocy Reconciliation Sheet) <br /> "veatocy variations exceeded the allowable Limits for this quarter. I <br /> 6eceby certify jjndec penalty of perjury that the source for the variation <br /> was sot due to as uasuthoriced (lea release. omen 13 of t <br /> lavcntocy )tecoociliation Sh, t <br /> List date, Caak I• or all vaciatiooa that a cee ed Che <br /> allowable li..its_ <br /> Oat c Tank I AmouaC <br /> Nig ,� <br /> all a _ <br /> ��j Y Litt_ .,tIC <br /> Additional dates/amounts chal l be conCiaucd oa a acparate �5t12V1�:�5 <br /> PaPee and aC(ached. <br /> [ f <br /> the source of Chc variation ..h.<h r-. <br /> c.•r•dcd a11u.+ahlc '11mtCs vas Aute Co <br /> leak Chc tnetden( shall be rrf.)rtc.f (.) <br /> _J � 1� 0 Env t Cona,cn(a l IIC�I t tl <br /> '"Ch" 24- hours and an unjuthn. . rcd r.- lr _l s.. rct•ort :ubatCted. <br /> ITIc QuarCecly aum:zary rePOrC shall toe aub.ei((ed ..tthtn 0 days of the end of cacti <br /> QvaCCCr I - January <br /> Q'.JCCCC 2 - Aprt ( --) Ju...- <br /> Quacccr ) - July --> ;Cpccmtwr <br /> Q.acter 4 - October --> Ikcreher <br /> Send Co' SAN JOAQUIN 1.O(,Al. HEALTIi DISTRICT <br /> 1601* f i'art•1t ..� ;;-1•..0 Itf►x Z0(j <br /> 1e ockcon CA ''LS'l01 4(,(�-Glbl <br /> 11(:1' 40 10/86 <br /> x i <br />