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BOARD OF TRUSTEES SAP' ')AQUIN LOCAL HEALTH DISTH,—T ------ - sERv1Ho------ <br /> James Culbertson, Praa. City of Lodi <br /> Patricia E. Vatnuoci, sec'y. <br /> AnlhonNN Van Spronun 1601 East Hazelton Avenue, P. O. Boz 2009 San Joaquin County <br /> City of Eaalon <br /> Eat Plmanlel Stockton, California 95201 City ityo Manteca <br /> Fara l ugbooL. Flo 209/488.8781 City of Ripon, <br /> Daniel L. Flores City of Stockton <br /> John D. Mut. M.O. City of Tracy <br /> William J. W Joel Khanna, M.O., M.P.H., District Health Officer San JosqufnCounty <br /> May Anna Lo.s Son JapuinCounty <br /> Facility Name 7 - ZZ4---V&—A/ 4, <br /> Address <br /> Date �'C'-�. 5 /`I�� Inspector <br /> MONITORING ALTERNATIVE #5 <br /> v'Annual 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 /> r <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 /> Precision test(s) must be performed by and results submitted to <br /> this office within 30 days of the test. <br /> C2 Pipeline leak detectors must be installed. on pressurized piping by <br /> 0-` Daily inventory reconciliation must be started itmediatejX, with records maintained <br /> at the facility for review. <br /> 4. Document daily check of suction piping function starting immediately. <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 variations that <br /> exceeded allowable. " The first statement is due by <br /> C Dispenser meter(s) must be calibrated by --S_ �_ 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 />