Laserfiche WebLink
f INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORM APR 19 1989 <br />/ i /' / <br />0 NOrrwl,01.01 , M"'. <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 Columa 13 of the Inventory 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 not due to an unauthorized (leak) rel"se. (Yes in Columm 13 of the <br />Inventory Reconciliation Sheet) <br />List date, tack f, and amount for all variations that exceeded the <br />allowable Limits. <br />Date Tank Amount <br />i. <br />2. <br />3. <br />4. <br />5. <br />Additional daces/amounts shall be continued on a separate sheet of <br />paper and attached. <br />Lf the source of the variation which. exceeded allowable limits was due to <br />a leak the incident shall be reported to S•J,L.H.D. Environmental Health <br />within 24 hours and an unauthorized release report submitted. <br />The quarterly summary report shall be aubmicted within 15 days of the end of each <br />quarter. <br />QuA rter 1 - January --> March <br />Quarter 2 - April --> June <br />Quarter 3 - July --> Scptemht:r <br />Quarter 4 - Octobcr --> tk:ccmber <br />Send to: SAN JOAQU IN LOCAL, HEALTH U i S'I'K ICI• <br />1601 E. Haze 1 i tm . P.O. KOM 2009 <br />SLockcon. CA 95201 466-67bl <br />11CT 40 10/86 <br />