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.... .. . •\n1v... rvvr � 4%. f,%ti 1 1 ! Lis*06"44 9Ef1VING <br /> Js"o Culbertson. Pini. V� � � Cllr of Lodi <br /> ralricAnfhoa o YannuOCI.wa son 1601 feast Hazelton Avenue P. Q. Box 2009 San JmqulnCounu <br /> Anff►or►.11.Van Bprons.n ' Gly o1 Eacalon <br /> Ead PUTWntaf Stodeton. California 95201' AYo Em:alca <br /> Fern svobe+ <br /> Daniel L. Home 209/46"781 City of Ripon <br /> John O. Masi. M.D. City Of Stockton <br /> William J. Wade Jogl Khanna, M.D.. M.P.N.. District il.alth DfticwCity of Tfacy <br /> San Joaquin County <br /> Mary Anne Law San Joaquin q County <br /> Facility Name La c_v <br /> Address �.- <br /> Date of Inspection 1 F7— inspector ,oe <br /> MONITORING ALTERNATIVE 15 <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 /> t/ Daily operational check of suction piping function. <br /> i! Calibrated meters for inputs and withdrawals: <br /> L, 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 /> 1 . Precision test(s) must be performed by 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 im ediately, with records ii+aintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediately. <br /> ( ,•,1 Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates nd variations that <br /> exceeded allowable. * The first statement is due by 151 OZ. <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. i <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 />