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BOARD OF TRUSTEES SPWAQUIN LOCAL HEALTH DIST SERVING <br />.lames Culbertson, Pres. City of Lodi <br />Patricia E. Vannuccl, See"y. San Joaquin County <br />Anthonette Van Spronsen 1641 East Hazelton Avenue, P. O. Box 2409 City of Escaion <br />Earl Plmentel Stockton, California 95201 City of Manteca <br />Fern Bupbee 209/466-6781 City of Ripon <br />Daniel L. Flores City of Stockton <br />John D. Mast, M.D. City of Tracy <br />William J. Weds Jogi Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br />Mary Anna Love San Joaquin County <br />Facility Name j Q-C-� rJ <br />,o <br />Address W, V ' /'C - <br />Date <br />C - <br />Date of Inspection _17-3ri _ `,! <br />Inspector <br />MONITORING ALTERNATIVE f5 <br />V -Annual precision test on tank(s) and piping. <br />Daily inventory reconciliation with submission of quarterly statement regarding <br />compliance with allowable variation. <br />AA Pipeline leak detectors on pressurized piping. <br />Daily operational check of suction piping function. <br />L"" Clibrated meters for inputs and withdrawals; <br />/Weights and Measures sticker <br />1,- 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 -7 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 />13-) Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <br />Document daily check of suction piping function starting immediately. <br />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 />V Dispenser meter(s) must be calibrated by _1 /—,2-3-7 with copy of <br />certification or Weights and Measures sticker number submitt_ed 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 />