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�t�-t_il-1'y�1 k1J=>ot-'hl hKUI'I (U H.iil <br />SAN JOAQ ,. COUNTY PUBLIC HEALTH S CES <br />��ONMENTAL HEALTH DIVISION <br />ANNUAL INVENTORY RECONCILIATION STOIARY REPORT <br />California LIST Regulations, Article 4, Section 2646 (j ) <br />1�s <br />Facility Name k?-�s4I <br />Address Z _ �` City �LI? <br />QAll inventory variations for the above mentioned facility were <br />within allowable limits of Title 23, California Code of Regulations, <br />ivision 3, Chapter 16, Sect on 2646, for the 22 month period from <br />19 to .�...,,.� 19 <br />17 Inventory variations in excess of the allowable limits of Section <br />2646, occurred as listed below. <br />I DATE I TANK 0/ PRODUCT I AMOUNT (Gallons) I <br />Submit report within 15 days following the end of the last month of the <br />12 -month period covered by the report. Report to be submitted to: <br />SM JOAQUIN COUNTY-■. r. SERVICMS <br />ENVIR014XZNTAL <br />P.O. BOX 2009 <br />STOCKTONo <br />I certify under penalty of perjury, that all variations (if any) <br />exceeding allowable limits are indicated above (California Health & <br />Safety Code, Section 25299): <br />N <br />Faci,lit� Tank Operator/Owner <br />EFS 23 019 8-1-92 <br />Date <br />