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loAl,o of TRUSTEES <br /> James Cult»rtson, Pres. *NIOAQUIN LOCAL HEALTH DWRO SERVING <br /> PatriciaCit <br /> of <br /> E. V nuccl, Secy. 1601 Eaat Hazelton Avenue P. O. Box 21709 San Joaquin County <br /> Anthonall• Vaa n Spransen ' <br /> Earl Pimentel Stockton. California 95201 ' oI(Y O Manteca <br /> Fern 111ugbee City Cityf Escalon <br /> Daniel L. Flores 2M/46"781 City of Ripon <br /> City of Stockton <br /> John D. Most. M.D. CitCISy of Tracy <br /> W1lflam J. Wada J041 Khanna. M.D.. M.P.H.. District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Fac i 1 i ty Name ( -I(,',j 'r'P- �L ',,1 c, Leo,S e. Pqc <br /> Address Y\11 A, f t'V ST P-A Z_ CQ <br /> Date of Inspection 2` 11-16 Inspector <br /> MONITORING ALTERNATIVE 15 <br /> nual precision test on tank(s) and piping. <br /> Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> 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 /> ZCertification by qualified repairman <br /> Implementation of this: monitoring alternative requires that the following CIRCLED items <br /> becompleted by the specified dates. <br /> 1 . Precision test(s) must be performed by and results submitted todk <br /> this office within 30 days of the test. ¢ .� <br /> 2. Pipeline leak detectors must be installed on pressurized piping by <br /> 3. 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 /> y. <br /> 5. Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variati ns that <br /> exceeded allowable.* The first statement is due by -- <br /> 6 Dispenser meter(s) must be calibrated by 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 1 <br /> 1 <br />