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�-AUARTERLf INVENTORYPORTING <br />Facility Name: _ 6, C"N <br />Facility Address: -- 7 75� W. 674"Uk <br />City: - —TLS/ <br />county: SRS J Opt Qt.', <br />State: <br />- <br />These were inventory variations that <br />exceeded the allowable limits for this <br />quarter. <br />Tank # <br />Size <br />Product <br />Explanation <br />i 2,00C <br />So <br />Z. <br />f2or, <br />EU <br />Records. review from <br />the last stable <br />1 <br />>7r - <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />calibrated. <br />Step 7 <br />Waste 011 <br />RECFjVWb0e,rtify that alt product level variations <br />'e mentioned e tloned facility were <br />NOV 2 Q in allowable limits for this quarter. <br />ENVIRONMENTAL HEALTH <br />LIST DATE, TANK # AND AMOUNT FOR ALL v94ftV0WFtvjrg.q OUT OF TOLERANCE <br />THAT EXCEED THE ALLOWABLE LIMITS. INVESTIGATIVE STEPS <br />Date <br />Tank # <br />Amount <br />Explanation <br />performed. <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />Records. review from <br />the last stable <br />situation. <br />Step 5 <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />calibrated. <br />Step 7 <br />Piping hydrostatically <br />tested. <br />�-Z-1 <br />Z <br />—� ► `1 <br />Li <br />`i <br />'zi3 <br />Send to (Local Agency): <br />Step.1 <br />Review Records. <br />Step 2 <br />New reconciliation <br />performed. <br />Step 3 <br />Shell Oil notified. <br />Step 4 <br />Records. review from <br />the last stable <br />situation. <br />Step 5 <br />Physical facilities <br />inspected for leaks. <br />Step 6 <br />Dispenser meters <br />calibrated. <br />Step 7 <br />Piping hydrostatically <br />tested. <br />Step 8 Underground storage <br />tanks precision tested. <br />Step 9 Additional investigation <br />as required by'Shell <br />or the local agency. <br />This quarterly summary report <br />shall be submitted within. 15 days <br />after the end of each quarter. Check <br />the quarter you are submitting <br />❑ Quarter 1 -- January thru March <br />Submit by April 15 <br />❑ Quarter 2 — April thru June <br />Submit by July. 15 <br />I�Quarter 3 — July thru September. <br />Submit by October 15 <br />❑ Quarter 4 - tgber thru December <br />'` Subihit by January 15 <br />L 1 O THI -FOR FOR YOUR RE6646' '.S <br />DEALEASIGWATURE ner= <br />