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80ARo Of TRUSTEES SAN JOAWIN LOCAL HEALTH DISTRICT <br /> Jamas Culbertson, Praa, SERVING <br /> Patricia E. vannuccl, Secy. qo <br /> City of ING <br /> odf <br /> Anthonelts Van Spronsen 1601 Eaat Hazelton Avenue, P. O. Box Zoog San Joaquin County <br /> Serf rn sugbesl Stockton, Calllornla 95201- Cltyof Escaion <br /> Daniel L. to City Of Mantece <br /> Darnel L. florae 209/186.6781 City of Ripon <br /> John 0. Meat, M.O. City of Stockton <br /> William J. Wade Jopl Khanna, M.D.. M.P.H., District Heallh Officer City of Tracy <br /> Mary Anna Lova San Joaquin County <br /> San Joaquin County <br /> Facility Name <br /> Address 0 p �(��� ,� Ro� , S7/ G,�r✓ <br /> Date of Inspection Inspector <br /> MONITORING ALTERNATIVE 15 <br /> Annual precision test on tank(s) and piping. <br /> Daily inventory reconciliation with submission of quarterly statement regardin <br /> compliance with allowable variation. 9 <br /> Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> VCalibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> certification by qualified repairfnan <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> Precision test(s) oust be performed by — <br /> this office within 30 days of the test. and results submitted to <br /> Pipeline leak detectors must be installed on 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 /> 5. 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 /> Z— <br /> O6 Dispenser meter(s) must be calibrated by Xc>C-- 3ti — <br /> certification or Weights and Measures sticker number submitted to thiswithcopy of <br /> office. <br /> If the above compliance dates cannot be met, contact this office prior to the specified <br /> date. <br /> II <br /> If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions . <br /> 3-86 UGT 1 <br /> � I <br />