10-Day Inventory Reconciliation Worksheet For Metered Usts
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110-DAY INVENTORY RECONCILIATION WORKSHEET FOR METERED USTs
Facility Name:
PBS Number:
Address:
Tank ID No:
Product Stored:
Inventory record for period from _____/_____/_____ to _____/_____/_____
D
D
START STICK
GALLONS
GALLONS
BOOK
END STICK
DAILY OVER (+)
A
A
INVENTORY
DELIVERED
PUMPED
INVENTORY
INVENTORY
or SHORT (-)
WATER
Y
T
[A]
[B]
(END - BOOK)
E
(GALLONS)
(GALLONS)
(GALLONS)
(GALLONS)
(INCHES)
(GALLONS)
[B] - [A]
(INCHES)
1
(+)
(-)
(=)
2
(+)
(-)
(=)
3
(+)
(-)
(=)
4
(+)
(-)
(=)
5
(+)
(-)
(=)
6
(+)
(-)
(=)
7
(+)
(-)
(=)
8
(+)
(-)
(=)
9
(+)
(-)
(=)
10
(+)
(-)
(=)
TOTAL GALLONS
TOTAL GALLONS
DELIVERED
PUMPED
(DROP SIGN)
TOTAL
TOTAL TANK
GALLONS
VOLUME
OVER / SHORT
COMPARE
At the end of the 10-day period, determine which of the above totals is the LARGEST
THESE
(TOTAL GALLONS DELIVERED, TOTAL GALLONS PUMPED or TOTAL TANK VOLUME)
TWO
and enter the number into the box below to calculate the ALLOWABLE VARIANCE.
NUMBERS
ALLOWABLE
× 0.0075 =
VARIANCE
L Is the TOTAL GALLONS OVER/SHORT LARGER than the ALLOWABLE VARIANCE? (circle one)
YES (see below*) NO
L Is there an INCREASE/FLUCTUATION/RECCURENCE of water in the bottom of the tank? (circle one)
YES (see below*) NO
* If you answered YES above, if the TOTAL GALLONS OVER/SHORT is LARGER than the ALLOWABLE VARIANCE, or if there
was an INCREASE/FLUCTUATION/RECCURENCE of water in the bottom of the tank – in accordance with 6 NYCRR Part 613.4(d),
the operator MUST initiate an investigation into possible causes. If WITHIN 48 HOURS the cause CANNOT be explained by inaccurate
recordkeeping, temperature variations, or other factors not related to leakage, the operator MUST notify the owner and the New York
State Department of Environmental Conservation (SPILL HOTLINE: 1-800-457-7362). The tank MUST be taken temporarily out-of-
service in accordance with Part 613.9(a) UNTIL such time that inspections and/or tightness tests are performed, the cause is determined
and necessary repairs or replacements are made.
EXPLANATION OF EXCEEDANCE OF ALLOWABLE VARIANCE
Cause determined to be:
Describe required action taken (i.e., inspection/repairs/tests, etc.) on
/
/
(date):
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