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QUARTERL INVENTORY FtPORTING <br /> Tank Size Product <br /> Facility Name: r ,(}S F""ep i /I 1 C-Facility Address: 725-6 El- W-4"q a" �g <br /> City: 76— / t1 <br /> County: `f <br /> State: C(A <br /> u � `O waste 011 <br /> I hereby certify under penalty of perjury that all product <br /> level variations for the above Mentioned facility were <br /> within allowable limits for this quarter. <br /> Inventory variations exceeded the allowable limits f CD C <br /> this quarter. I hereby certify under malt of er <br /> F] <br /> g Y Y penalty P j <br /> that the source for the variation was NOT due to an J U L 17 1991 <br /> unauthorized (leak) release. ENVIRONMENTAL HEALTH <br /> List date. tank # and amount for all variations PERMIT/SERVICES <br /> that exceed the allowable limits <br /> Date Tank Amount Date Tank E Amount <br /> -z4--ay 4- 2 t z-11$. 31 S e 70 7C) - <br /> -30 /-*0 J- -I -Wr / � y ... /oat ;V Z2 <br /> n 14, X -1- 72,f b:Are 30-3 cL 2 14, "(A -/72= <br /> � 1b !f r7?--ro tssr -2r-30 ¢ 2-7O <br /> «�16 Joe-! -c3- 4,20 3 -4- ,,V7- rss <br /> -/o3-8Sr- 9'3 04- 3d 3 4-XF2— <br /> �"'l,�'-13 <br /> The quarterly summary report shall be submitted within 15 days <br /> of the end of each quarter. <br /> Quarter i - January thru March Submit by April 15 <br /> Quarter 2 - April thru June Submit by July 15 <br /> Quarter 3 - July thru September Submit by October 15 <br /> Quarter 4 - October thru December - Submit by Januury 15 <br /> Send To (Local Agency) : <br /> Q <br /> KEEP COPIES OF THIS FORM FOR YOUR OWN RECORDS <br /> DATE MAILED 7 rQ <br />