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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> 7/2/87 <br /> Facility Name: LONE STAR INDUSTRIES INC. Tank i <br /> Size Product <br /> Facilit Address: 30350 S. Tracy Blvd. 1 1 000 UNLEADED <br /> Y 2 10 000 DIESEL <br /> Tracy, a. 3 1,000 D L' E ) <br /> Telephone : 209-835-1454 0 WASTE OIL <br /> Person Filing 5 7 000 DIESEL ( 56 ) <br /> Report RICH BIER <br /> X� I hereby certify under penalty of perjury that all inventory variations for <br /> the above mentioned facility were within the allowable limits for this <br /> quarter. (No in Column 13of the Inventory Reconciliation Sheet) <br /> ElInventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the variation <br /> vas not due to an unauthorized (leak), release. (Yes in Column 13 of the <br /> Inventory Reconciliation Sheet) <br /> List date, tank i, and amount for all variations that exceeded the <br /> allowable limits. <br /> Date Tank lk Amount <br /> 1. <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> Additional dates/amounts shall be continued on a separate sheet of <br /> Paper and attached. <br /> If the source of the variation which. exceeded allowable limits was due to <br /> a leak the incident shall be reported to S .J . L. H . D . Environmental Health <br /> within 24 hours and an unauthorized release report submitted. <br /> The Quarterly summary report shall be submitted within 15 days of the end of each <br /> Quarter. <br /> Quarter I - January --) MarchFZ1`1v J:91 .,21 <br /> iartcr - April --> June �y1 3., ;r: Ld�ij <br /> Quarter 3 - July --> September ' <br /> Quarter 4 - October --) lkcember 4Y <br /> `i 37 <br /> Send to: SAN JOAQUIN LOCAL HEALI-Ii DISTRICT <br /> 1601 L . Hazelton . I' . 0 . li()x 2OENVIRGME:�TAL HEALTH <br /> (19 IrERNIIIT/SERVICES <br /> Uc;T 40 10/86 Stockton , CA 95201 466 -6761 <br />