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PUBLIC HEALTH SERVICES or oz <br /> SAN JOAQUIN COUNTY <br /> JOGI KHANNA M.D.,M.P.H. <br /> Health Officer cu p <br /> \IIFOPv.i <br /> P.O. Box 2009 • (1601 East Hazelton Avenue) • Stockton, California 95201 <br /> (209) 468-3400 <br /> Facility Name �e-tfs E2ce <br /> Address <br /> Date of Inspection 3 S <7 Inspector <br /> MONITORING ALTERNATIVE #5 <br /> Annual precision test on tank(s) and piping. <br /> Daily inventory reconciliation with submission of quarterly <br /> statement regarding compliance with allowable variation. <br /> Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> Caleb ated 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 <br /> CIRCLED items be completed by the specified dates. <br /> 1. Precision test(s) must be performed by �- -, - qo and results <br /> submitted to 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 <br /> records maintained' at the facility for review. <br /> 4 . Document daily check of suction piping function starting <br /> immediately. <br /> 5. Submit quarterly statement to this office that allowable variation <br /> on inventory reconciliation has not been exceeded or a list of <br /> dates and variations that exceeded allowable. *The first statement <br /> is due by -?-/6 -'/0 <br /> 6 . Dispenser meter(s) must be calibrated by �U,rreA with a copy of <br /> certification or Weights and Measures sticker number submitted to <br /> this office. <br /> If the above compliance dates cannot be met, contact this office prior to <br /> the specified date. <br /> * If allowable daily inventory variation is exceeded, refer to Section <br /> 2644 (f) for required actions. <br /> EH 23 001 4/89 <br /> A Division of San Joaquin Counry Health Care Services <br />