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INVENTORY RECONCILIATION <br /> QUARTERLY SUMMARY REPORT FORM <br /> Faci.l.iLy Name: RIMC LONESTAR Tank # Size Product <br /> 1n ea e <br /> Fac-ili. Ly Address : 30350 S . Tracy Blvd. 2 19, 000 <br /> Diesel <br /> Tracy, Ca. — 3 —jam-" iese <br /> Te.lcl�hone: 20 9- 8 3 S- — — 51-II Diesel <br /> Person Filing <br /> Report : LLOYD S . BURNS <br /> I hereby certify under penalty of perjury that all inventory variations <br /> for the above mentioned facility were within the allowable limits for <br /> this quarter . (No in Column 7.3 of the Inventory Reconciliation Sheet. ) <br /> Inventory variations exceeded the allowable limits for this quarter. I <br /> hereby certify under penalty of perjury that the source for the varia- <br /> ❑ Lion was not due to unauthorized ( leak) release. (Yes in Column 13 of <br /> the Inventory Reconciliation Sheet ) . <br /> List date, tank # , and amount for all variations d <br /> ed <br /> the allowable limits . IWNRAW <br /> REC <br /> Date Tank # Amount q p s <br /> -- �F,r11 R 5 tr0 <br /> Et" <br /> 1 . V!ROWS � <br /> 2 . _ PERMITXSERL HEA`TI~ <br /> 3 . CES <br /> 4 . <br /> 5 . <br /> Additional dates/amounts shall be continued on a separate sheet <br /> paper and attached . <br /> 11 the source of the variation which exceeded allowable limits was <br /> clue to a leak, the incident shall be reported to San Joaquin Local <br /> Health District; Environmental Health Division, within twenty-four <br /> ( 24 ) hours and an unauthorized release report submitted. <br /> The cluri r ter. l y summary report shall_ be submitted within fifteen ( 15 ) days <br /> of the end of each quarter . <br /> uarter ]- January---------->March <br /> Quarter 2 - Api. i.1 -- --- ------ - June <br /> Quarter 3 - July-------------->September <br /> Quarter 4 - October----------->December <br /> Send t_o: SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 E. Hazelton, P.O. Box 2009 <br /> Stockton, CA 95201 468-3420 <br /> ATTEN: JAIME FAVILA <br /> Ifl 21 019 ,10/86 <br /> ce <br /> 3,ll.L <br />