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QUARTERP1( INVENTORY P&1 <br />Facility Name: �G L ���0 �cAwf <br />Facility Address: N • ( 17ouoL) <br />City: 5���� t'o' <br />County: SAN Aq�u-„3 <br />State: C A I X. — Now <br />REC E t <br />Tank # <br />Size <br />Product <br />Explanation <br />to -2,i <br />jl-1, � U v u <br />-4AQ, <br />Ulu <br />2,c-�00 <br />V <br />1 (JJ J <br />-izCJL. -Lou J <br />situation. <br />Step 9 <br />r r - At A6JL <br />as required by Shell <br />or the local agency. <br />ll- <br />Waste Oil <br />These were inventory variations that JAN 1 ®�g�' hereby certify that all product level variations <br />exceeded the allowable limits for this for #) q above mentioned facility were <br />quarter. ENVIRONMENTAL H6A - AiVallowable limits for this quarter. <br />PERMIT/SERVICES <br />LIST DATE, TANK # AND AMOUNT FOR ALL VARIATIONS <br />THAT EXCEED THE ALLOWABLE LIMITS. <br />Date <br />Tank # <br />Amount <br />Explanation <br />to -2,i <br />r)— <br />-4AQ, <br />a k -k -A, '62 <br />Step 4 <br />Records review from <br />+yet <br />the last stable <br />situation. <br />Step 9 <br />r r - At A6JL <br />as required by Shell <br />or the local agency. <br />ll- <br />s P"Good;�. <br />+ b ? Z <br />((, Acrk <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 />Step 8 <br />the last stable <br />situation. <br />Step 5 Physical facilities <br />This quarterly summary report <br />shall be submitted within 15 days <br />after the end of each quarter. Check <br />the quarter 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 />❑ Quarter 3 — July thru September <br />Submit by October 15 <br />Quarter 4 — October thru December <br />Submit by January 15 <br />Send to (Local Agency): SP11-:S0twi1 <br />KEEP COPIES OF THIS FORM FOR YOUR RECORDS <br />DEALER IG TU E DATE <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 />shall be submitted within 15 days <br />after the end of each quarter. Check <br />the quarter 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 />❑ Quarter 3 — July thru September <br />Submit by October 15 <br />Quarter 4 — October thru December <br />Submit by January 15 <br />Send to (Local Agency): SP11-:S0twi1 <br />KEEP COPIES OF THIS FORM FOR YOUR RECORDS <br />DEALER IG TU E DATE <br />