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411INVENTURY RECONCIWATION <br /> �)UARTI.-',RLY GUMMnRY HKPORT FORM <br /> i L Hame : W LONESTMI Tank I size Product <br /> Facilill Addrens : 10310 S . "Tracy Blvd . 10 000 MAP!— <br /> - Wafy;-rn , <br /> T" Icph"un: <br /> Pe r son P i 1.l-ni6� <br /> ReV"rh­­­ LLOYD S . BURNS <br /> I hereby cerK - e "nder penalty of perjury that all inventory variations <br /> for the above annJuned rac:imy were within the allowable limits ful- <br /> this qiater . 1 % in Column 13 of the Inventory Reconciliation Sheet . ) <br /> Wve"Lury v taulntlp <br /> exceeded the allowable lim!Ls for Lhin quarLer . I <br /> hereby cert , , VlIdez penalty of perjury that the source for the varia- <br /> Lin" was nu� hu "lla"Lhurized ( leak ) release. ( Yes in Column 13 of <br /> 'tan Inv-HW ; naco"ciliatio" GheeL ) . <br /> tank 0 , and amotint- for all variaLions Lhat exceeded <br /> DaLc Tank N Amount <br /> 2 . <br /> 3 . <br /> 0 6 1992 <br /> OVIRONMENTAL HEALTH <br /> PERWISERNES <br /> 0jLvs/a111,u"Ls shall be continued on a separate sheat, <br /> VaVer nh, VILVOChed . <br /> the Sou <br /> thfvariation which exceeded allowable limits was <br /> cls:a ' Lo ,a ls _ . ntnp incident shall he reported to San Joaquin Local <br /> 110ilth Dtskyi-w ; Anvironmental "ealLh Division; within LwenLy-four <br /> hell:; a PA& ni "naulh"uizod release report submitted . <br /> (Witer lY u "mayy rvpwn shall be submiLLed within fifLeen ( 15 ) days <br /> Of the cad of ea "uarter . <br /> January---------->March <br /> G. 1111 t l ._.. ---------ndllrle <br /> Quarter I duty------------->Seplaember <br /> Quilt c,-!r 4 OcLohei------------>December <br /> Send VY JOAQUIN LOCAL HEALTH DISTRICT <br /> E. Hazelton, P.O. Box 2009 <br /> MoXton, CA 95201 460-3420 <br /> '1'3N: JAME l "TIA <br />