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AOL <br /> WV <br /> owl", <br /> QUARTERLY INVENTORY REPORTINGt <br /> Tank # Sizeoduct <br /> Fac 1l1ty Name: 06&s o d <br /> Fac i 1 ity Address:= A`� <br /> city. r <br /> County: / r <br /> State: <br /> Waste 011 <br /> I hereby certify under penalty "f perjury that all product <br /> level variations for the above mentioned facility were <br /> within allowable limits for this quarter. <br /> ventory variations exceeded the allowable limits for <br /> is quarter. I hereby c tify under penalty of perjury rH <br /> that the source for the variation was NOT due to an <br /> unauthorized (leak) release. <br /> L Pc <br /> List date. tank # and amount for all variations <br /> that exceed the allowable limits <br /> Date Tank Amount Date Tank Amount <br /> f r <br /> ® t <br /> , . <br /> P.-io <br /> The- qUarterly summaryreport shall be submitted within <br /> of the and of each t . <br /> Quarter i - January thru 14archbit by April 15 <br /> Quarter — April thru June t by July 15 <br /> Quarter 3 — July thru September — Submit by October 15 <br /> Quarter 4 — October thru December — Submit by Janaury 15 <br /> Send T cal n !- <br /> C E �- <br /> KEEP COPIES OF THIS FORM FOR YOUR OWN RECORDS <br /> DATE MAILED <br />