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10-DAY INVENTORY RECONCILIATION WORKSHEET FOR METERED USTs Facility Name PBS Number Address Tank ID No Product Stored Inventory record for period from // to // D START STICK GALLONS BOOK END STICK DAILY OVER A INVENTORY DELIVERED PUMPED or SHORT - Y T E - TOTAL GALLONS INCHES B END - BOOK B - A WATER TOTAL OVER / SHORT TOTAL TANK VOLUME At the end of the 10-day period determine which of the above totals is the LARGEST and enter the number into the box below to calculate the ALLOWABLE VARIANCE. DROP SIGN COMPARE THESE TWO NUMBERS ALLOWABLE VARIANCE 0. 0075 L Is the TOTAL GALLONS OVER/SHORT LARGER than the ALLOWABLE VARIANCE circle one 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-ofservice 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. 0075 L Is the TOTAL GALLONS OVER/SHORT LARGER than the ALLOWABLE VARIANCE circle one 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. 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-ofservice 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. The tank MUST be taken temporarily out-ofservice 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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