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0 <br /> r r C, <br /> INVENTORY REC.ONC.I.LI-A1 .100 <br /> Q. <br /> QuAlt-1'1-ltlrY SUMMARY REPORT 1 M <br /> N Y ' <br /> Pa i l i I:y Name: RM" LONES'['ARtank � "� Size ,"Pr <br /> N oduct <br /> ---I <br /> n_ e a e <br /> Favi l i I:y Address 50350 S. Tracy Blvd . --2 , p00 It el~ <br /> 10 <br /> g3p q 7 S 7 000 J1iesc,l -��-6'2)— <br /> 'I('L/'!)llf)lie: - 209 - OJJ-1�Jt <br /> Person H11-lig <br /> t <br /> Repos:t_ LLOYD S. BURNS ----- <br /> _ I hereby certl fy tender penal.Ly of per jury that all invent-ory vari.aLfom <br /> ff . L.IIe 11)(We •ner� 'Jonecl rac:i.li t-y were wi Lhin the allowable l.inli Ls for 1-111s, quarter. . O( > in Column 13 of Lhe lnvenLor ReconciliaL-ion SheeL . <br /> i , <br /> j i ;lventory v.ar- 'al-i m s exceeded the al lowabl-e li.IniL-s for this yucll:ter . I <br /> li l h=,reby cern ,? usIdet penalty of perjury that the :source for Lhe vari,a- <br /> ! —J I.i all was no L- Out? to mmuthori zed ( leak ) release. ( Yes in column 1.3 of <br /> 1 ►1e invenLory SheeL ) . ----- <br /> I,isl_ (l��l.t , Lsi11k 0 , and amount for all variations that exceeded <br /> Lhe <br /> 1 <br /> _a L 'Tank i! AmounL <br /> 2 . <br /> 4 . <br /> -i r) <br /> i <br /> Addi ijo►oai. (Ii)L(!s,/amounLs shall he conL-i.nued on a separaLe sheet <br /> 'i <br /> pnt)cr nl%cl s'�- tache( . <br /> Lhe sour:('--, .'Tf Lhc: va iaL.i.on which exceeded allowable 11111i Ls was <br /> i <br /> du(2to a lr,-1 )-he -incident shall lie reporLed to San Joaquin Local <br /> '• ;,`s•;i ronment:al Ileal.t-h Division; wi.th.in Lwenty-Cour <br /> 11mirs and ilij Illtillll h()1' 1 TC`(l rel cilf;e 1 ('poCt l3nl)IIII.I:ted . <br /> p <br /> The (hili r t_er l y ,I; frrnc , y rc�pftt 1, shall be submitted wi Lhi n f i.f Leen ( 15 ) clays <br /> of. Lhe rt1d of ei(cli ,. ial: Ler . <br /> it t; n�)r1 (�r 1. - hilt► i t ._.. - -------- ..-----:June <br /> cpltlr. loco: 3 II.I l y------------•-->SepLenlber <br /> 'I Qtiart:uo- 4 - ocl_o1) l------------>I)ecemher <br /> Scild t O: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1x;01 B. Ilazell.on, P.O. Box 2009 <br /> €i :t;t,latvn, CA 95201 460-3420 <br /> - !1T1'1 N; JnII` E FAVILA <br /> sal I i III '! 1 f)/1i Ci r <br />