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BOARD OF TRUSTEES SAN#AQUIN LOCAL HEALTH DISTRIf SEAVIHai <br /> James Culbertson, Prot. City of Lodi <br /> Patricla E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> City of Escalon <br /> Anthonette Van Spraneen Stockton, California 95201 City of Manteca <br /> Earl piment <br /> City of <br /> Fern Bugbee 209/468-6781 Ripon <br /> Daniel L. Flores _ _ City o}Stoctktton <br /> _ <br /> John D. Mast. M.O. City of Tracy <br /> William J. Wed• Joyi Khanna, M.D.. M.P.H.. District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Name <br /> Address <br /> Date of Inspection / Inspector �C <br /> r <br /> 146- 7 <br /> MONITORING ALTERNATIVE 95 ��lU/` � "` Sr ( Y <br /> !/Annual precision test on tank(s) and piping. <br /> lDaily 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 /> t,-tertification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> completed by the specified dates. !� <br /> Precision test(s) must be performed by T - " 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 /> L� at the facility for review. <br /> ( 4. ) Document daily check of suction piping function starting immediately. <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 byi,_ - 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 />