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HARD OF TRUSTEES SAI JAOUIN LOCAL HEALTH DIS1f T SERVING <br /> James Culbertson, Pfeil. City of Lodi <br /> PIIfICII E, Vannuccl, Secy, 1601 East Hazelton Avenue P. 0. oz 2009 San Joaquin County <br /> Anlhonelle Van Spronsen ACity of Eacalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern DanielBugL. �� 2 1 I CllyofRipon <br /> FernL. FioreFioa 209/466-6781 <br /> John D. Mast, M.D. a City of Stockton <br /> City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Name �C—Fo — �rjo+e /' <br /> Address 3g E• s car 12eriier Ed . 5 f ock4o✓I <br /> Date of Inspection 9 /5— S 7 Inspector 0--;w a <br /> MONITORING ALTERNATIVE 05 <br /> ✓ Annual precision test on tank(s) and piping. <br /> ✓ Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> NIA Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker/ <br /> Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> l� Precision test(s) must be performed by I0—3f—$7 and results submitted to <br /> this office within 30 days of the test. <br /> 2. Pipeline leak detectors must be installed on pressurized piping by <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediate. <br /> Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variations that <br /> exceeded allowable.* The first statement is due by <br /> Dispenser meter(s) must be calibrated by 10- 31- 37 with copy of <br /> certification or Weights and Measures sticker number submitted to this office. <br /> If the above compliance dates cannot be met, contact this office prior to the specified <br /> date. <br /> * If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions. <br /> 3-86 UGT I <br />