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SOARU OF TRUSTEES SAN-JOAQUIN LOCAL HEALTH DISThfPi.T SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1801 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonetle Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern eupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.N., District Health Officer San Joaquin County <br /> Mary Anna Love G San Joaquin County <br /> Facility Name 7- �Gl��i /,Q -5�7e, <br /> / ?/2 <br /> Address `� (i�'1Q� 7 �'P.(� l�D. Thr+ 61, <br /> Date of Inspection 4' (q a Inspector <br /> MONITORING ALTERNATIVE #5 <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 /> Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> V'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. N�(,y rrs ALTS <br /> 1 . Precision test(s) must be performed by a'� r0 and results submitted to <br /> this office within 30 days of the test. <br /> C3� Pipeline leak detectors must be installed on <br /> pressurized piping by <br /> 3 Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> 4. Document daily check of suction piping function starting immediately. <br /> 3 <br /> Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates /vai�ations that <br /> exceeded allowable.* The first statement is due by <br /> i <br /> tS. 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 />