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Facility <br />Facility <br />Telepao <br />Person <br />Reporc <br />*VENTORY r <br />QUARTERLY SUMMARY.;�. �. <br />RECEIVED <br />rrr 99; <br />�� a <br />I hereby certify under penalty of Perjury that all 'inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />quarter. (No in Column 13 of the lovecocy Reconciliation Sheet) <br />Inventory variations exceeded the allowable limits for this quarter. I <br />hereby certify under penalty of perjury that the source for the variation <br />vas aot due to an unauthorized (leak) releise. (Yes in Colum 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tank 1. and anounc for all variations chat exceeded the <br />allowable Limits. <br />Date Tank 0 Amount <br />S. <br />Additional dates/amounts shall be concsoued on a separate sheet of <br />paper and attached. <br />EE the source of the variation which. exceeded allowable limits was due Cc <br />a leak the incident shall be reported to S.J.L.H.D. Environmental Ucslch <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be submitted within 15 days of the end of each <br />quarce:r. <br />QuArteer 1 - January --' March <br />Quarter 2 - April --' June <br />Quarter 3 - July -®> September <br />Quarter 4 - October --> tk:ce*tuber <br />Send cc: SAN JOAQU IN LOCAL HEALTH U i S'CIt 1 CT <br />160L E. gaze• 1 t e►tt . 1)-0- 11" 2O()e3 <br />Slockcon. CA 95201 466-67bl <br />Uc;T 40 10/86 <br />