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BOARD OF TRUSTEESSAN J�AQUIN LOCAL HEALTH DISTRICT SERVIND <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonetle Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, Callfornla 95201 City of Manteca <br /> Fern Bupbee 209/466 6761 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.H., District Health Officer San Joaquin County <br /> Mary Anna Love /� San Joaquin County <br /> Facility Name JZ/ 4G�,� 6fC7jeI9 (,U , / <br /> Address 12-? 2Q � � !"1`1 l�f�r/ 6A �����l b <br /> Date of Inspection 1= = Inspector <br /> MONITORING ALTERNATIVE 15 <br /> nnual 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 /> Lt4ights 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. 3_ 8 7 <br /> I I / Precision test(s) must be performed b_ 4 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 /> f <br /> 3.� Daily inventory reconciliation must be started immediately, with records maintained <br /> lT- 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 date and vari ions that <br /> exceeded allowable.* The first statement is due by —�?e <br /> "� <br /> /I 6. /Dispenser meter(s) must be calibrated by _ with copy of <br /> 4/ 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 />