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DUAKU Cil' iRUSTEES SAP AQUIN LOCAL HEALTH DISTR# SERVING <br /> James Culberl@on, Pre@. Clty or Lod <br /> Patricia E. Vannuccl, Secl <br /> San Joaquin i <br /> y. <br /> Anthonette Van Spronaen 1601 6a3t Hazelton Avenue, P. O. BOX 2009 q n Count <br /> Earl Plmentel Stockton, llfCaornla 95201 City of Escalon Fern Sugboa City of Manteca <br /> Daniel L. Flores 209/468-6781 Clty of Rlpon <br /> John D. Mast, M.D. _ - <br /> City of Stockton <br /> William J. WadeCity of Tracy <br /> Joel Khanna, M.D., M.P.H.. Dlatrlel Health Officer an Joaquin Count <br /> Mary Anna Love SY <br /> San Joaquin County <br /> Facility Name <br /> Address { C <br /> Date of Inspection (_ Inspector <br /> i4 r r <br /> MONITORING ALTERNAT UE d5 <br /> Annual precision test on tank(s) and piping. <br /> LI-11-1 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 /> Heights and Measures sticker <br /> ``Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> Abe completed by the specified dates. <br /> Precision test(s) must be performed by L{ - l - ' 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 /> nDaily 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 /> ( o•) Dispenser meter(s) must be calibrated by _ � - ��� 7 with co of <br /> certification or Weights and Measures st. ieker number submitted to this offiice. <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 11f,T I <br />