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�lUARTE &INVENTORY 4.PORTING <br />Facility Name: (�o:R4 <br />Facility Address, -2 3 -2,0 <br />City. (�40QA41j_> S'jo q <br />County: �AQL4;,*) <br />State: <br />These were inventory variations"thaf I hereby certify that all product level variations <br />exceeded the allowable limits f0pfthj�sfq jE932 El for the above mentioned facility were <br />quarter. within allowable limits for this quarter. <br />LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS <br />THAT EXCEED THE ALLOWABLE LIMITS. <br />Date <br />Tank # <br />Amount <br />Explanation <br />Step 2 <br />New reconciliation <br />4 T'ihj <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />----------- — — -- T r <br />the last stable <br />198(c <br />situation. <br />Step 5 <br />Physical facilities <br />(a <br />inspected for leaks. <br />Ili <br />2 <br />'u—) <br />(20 100, <br />Step 7 <br />Piping hydrostatically <br />tested. <br />Step 8 <br />Underground storage <br />tanks precision tested. <br />Step 9 <br />Additional investigation <br />as required by Shell <br />or the local agency. <br />This quarterly summary report <br />OUT OF TOLERANCE <br />INVESTIGATIVE STEPS <br />Step 1 <br />Review Records. <br />Step 2 <br />New reconciliation <br />performed. <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />Records review from <br />the last stable <br />situation. <br />Step 5 <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />calibrated. <br />Step 7 <br />Piping hydrostatically <br />tested. <br />Step 8 <br />Underground storage <br />tanks precision tested. <br />Step 9 <br />Additional investigation <br />as required by Shell <br />or the local agency. <br />This quarterly summary report <br />after the end of each quarter. Check <br />the,guarter you are submitting <br />Quarter 1 — January thru March <br />Submit by April 15 <br />■Quarter 2 — April thru June <br />Submit by July 15 <br />El Quarter 3 — July thru September <br />Submit by October 15 <br />El Quarter 4 —October thru December <br />Submit by January 15 <br />Send to (Local Agency): _�-OAOU'112 (_"t4At t—�_-tL <br />H <br />-4 <br />KEEP COPIES OF T FORM FOR YOUR RECORDS <br />9 2 - <br />DEALER SIGNATUAE I DATE <br />