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BOARD TRUSTEES SIN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culul TRUSTEES <br /> Pres. <br /> Patricia E. Vannuccl, Secy. City of Lodi <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Earl Plmentei Stockton, California 95201 city of Escaion <br /> Fern Bupbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John 0. Mast, M.D. City of Stockton <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer City of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> Fac i 1 i ty Name —ilw�`L)V � (j, <br /> Address �(} /�lC�z �L v7 Lai& <br /> Date of Inspection Inspector <br /> MONITORING ALTERNATIVE #5 Z— A96) t� a � T. <br /> 1/ 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 /> Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> 1G Precision test(s) must be performed by '3—/.S'Sq 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 _/U/14 <br /> 0 Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> C� Document daily check of suction piping function starting immediate. <br /> C5,' Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates an ,v ns that <br /> exceeded allowable.* The first statement is due by,,.�� /1 �� / <br /> C6 Dispenser meter(s) must be calibrated by 3 — /' �j�7 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 />