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INVI'NTORY RECONCILIATION <br /> QUARTFAILY SUMMARY REXORT FORM <br /> FaciliLY Naille: RMC LONESTAR <br /> Tank <br /> Size Product <br /> y A(I(Ij-eFc3 : 30350 S. Tracy Blvd. I 1 , 000 --LFnT-e-ad-eU- <br /> 10 0 0 0--- --f <br /> 2 ---2--- --D <br /> _Tracy,, Ca . '=?T 1 000 <br /> 110: ---------- 209- 835- 1454._.... <br /> 09- 8 3 1 S--14 1�S-4-- 3 ------ -�ie s e <br /> F Ing 7 000 <br /> it <br /> (_ : Bill Kelton <br /> I hereby certify Under penalty <br /> y of perjury that all inventory vari.aLions <br /> for the above mentioned faci-lit-y were wiLldn the allowable limiLs for <br /> 1.1ils quarter. (NO in Column 13 of Ihv InvenLory lleconcil.iaLion SIleeL- . ) <br /> liivenLory variati-ons, exceeded the a1I0w8I)I-e 1i-miLsfor th1s, quarter. I <br /> hereby cert'fy Ull(Jer Penalty of perjury that the source for the vari-a- <br /> I-i0" was not due to unauthorized ( teak ) release. (Yes- in Column 1-3 of <br /> e <br /> the InvnLory Reconci .liation sheet ) . <br /> I-i ,13t- date, Lank 11 , and amount for ill ]. variations that exceeded <br /> the allowable -limiLs . <br /> Date Tank-4 Amount <br /> 2 . <br /> 3 . <br /> 4 . <br /> Add i Li onal dateshimounLs shall be continued oil a separate sheet <br /> and attachod . <br /> t'll(' Source Of Lhe vati.aLion which exceeded allowable limits was <br /> due to a teak, the, ill(,-j-cjejlt shall he reported to San Joaquin Local <br /> Health I)i.sLi--.i(,L ,, I'llvi-F-011ment-al Ilealth Division, wi-Llihi twenty-four <br /> ( 24 ) hours and all unauthorized release report submitted. <br /> The (Ilim-terly nilminary relmrl-. shall 1)(! SUbmi-tLed wi.Lhin fi-fLcen ( 15 ) days <br /> of LIW end of each quai. Ler . <br /> Quarter I <br /> Api i B lune <br /> y-------------->SepLember <br /> Quarter 4 0C 1-0 1)c t ------------>Decembe r <br /> Send I SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1601 F% Hazelton, P.O. Box 2009 <br /> Iftockton, CA 95201 468-3420 <br /> ATTEN1 JA-IME FAVILA <br /> 3 (W) 10/86 <br />