Laserfiche WebLink
RECEIVE; <br /> INVENTORY RECOrIcILIATION APR 2 2 1992 <br /> QUARTERLY SUMMARY REPORT F(ENVIRONMENTAL <br /> l. #� <br /> Facility Nam.: 0aa (17(l D� 'le/z..(' PERMIT/SERVICES <br /> Tank f e. <br /> )LZC Product <br /> Fac. icy Address: /5 i . <br /> Telephone : �! <br /> Person Filing ------ <br /> Report <br /> I hereby certify under penalty of perjury that all inventory <br /> the above mentioned facility were within the allowable limiusvarforatithis$ for <br /> Quarter. (No in Column 13 of the Inventory Recoaciliation 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 /> was not due to an unauthorized (leak) release. (Yes in Cold 13 of the <br /> Inventory Reconciliation Sheet) — <br /> List date, tank /, and amount for all variations that exceeded the <br /> Allowable limits. <br /> Date Tank I Amount <br /> 2. <br /> 3. <br /> 4. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> Paper and aCtached. <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. li. D. Environaental Eiealth <br /> Within 24 hours and an unauthorized rrlease report submitted. <br /> The quarterly summary report shall be •,abmitCed within IS �l.a <br /> q��arcrr . P <br /> Y=; ('k the encs of oach <br /> Quarter I - Janunry --J Narch��12� <br /> Qva - April --> Julie <br /> Quarter 3 - July --> :;cptembr.r <br /> Q's-irter 4 - October --> <br /> December <br /> Send cc: SAN .JOAQUIN LOCAL HEALTH UISTRIC1' <br /> 1601 F . Hazelton , I' .0 . Box 2009 <br /> Stockton. CA 95201 466-6781 <br /> UCT 40 10/86 <br />