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1 <br /> RGARD OF TRUSTEES �N JOAQUIN LOCAL HEALTH DWICT SERVING <br /> amec-f UIbertaon, Pres. City of Lodi <br /> Patricia E. Vannucci, Secy• 1601 East Hazelton Avenue, P.0. Box 2009 San Joaquin County <br /> Anthonett•Van Spronsen City of Escalon <br /> Ead Piment*t Stockton, Callfornia 95201 City of Manteca <br /> Y of <br /> 209/46"781 Cit <br /> Fern i3uptaes Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Most, M.D. City of Tracy <br /> William J. Wads Jogi Khanna. M.D., M.P.H.. District Health Officer San Joaquin County <br /> Mary Anna Low Satz Joaquin County <br /> y <br /> Facility Name rt.. 1� Z' � ;�'.����i;:`; �,�; �,d j- 4; <br /> Address <br /> ` i <br /> Date of Inspection Inspector� _ ��! _ - <br /> MONITORING ALTERNATIVE #5 <br /> ,,-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 /> r`- -f Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> 1 . )Precision test(s) must be performed by <br /> and results submitted to <br /> this office within 30 days of the test, <br /> pipeline leak detectors must be installed on pressurized piping by l <br /> _ - <br /> ,—, Daily efacility for <br /> ithifacil� oreviewtion must be started immediately, with records maintained <br /> 4. Document daily check of suction piping function starting immediately. <br /> i'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 /> 6. Dispenser meter(s) must be calibrated by /;�!/' 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 /> 3-136 UCT 1 <br />