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a <br />INVENTORY RECONCILIATION <br />QUARTERLY SUMMARY REPORT FORN <br />41 <br />Facility Address: <br />W 'k <br />I hereby certify under penalty •.. perjury that 411 inventory variations for <br />the above mentioned facility were within the allowable limits for this <br />Y.uarter. (No in Column 13of 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 />was not due to an unauthorized (leak) release. (yes in Column 13 of the <br />Inventory Reconciliation Sheet) I <br />List date, tank 1, &ad amount for all variations that exceeded the <br />allowable limits. <br />Date Tank F Amount <br />1. <br />2. <br />3. <br />4. <br />S. <br />Additional dates] unto shall be continued on a separate sheet of <br />paper and attached. <br />If the source of the- variation which,exceeded al-towabte limits was due to <br />& leak the incident shall be reported to S.J.L.H.D. Environmental Heat <br />within 24 hours and an unauthorized release report submitted. I <br />The quarterly summary report shall be submitted within 15 days of the end of each <br />quarter. <br />Quarter I - January March <br />Qviarter 2 - Aprit June <br />Quarter 3 - July Septcmhcr <br />Quarter 4 - October D-ccember <br />.,:`.Stead t ;SAN -i kqtilN 'b.GAL-AEALT�t <br />:� 0 <br />1601 E. Haze licall . P.O. Box 2009 <br />Stockton, (.A 95201 460-67bi <br />OCT 40 10/86 <br />