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BOARD OF TRUSTEES SAITIOAQUIN LOCAL HEALTH DISTRUT SERVING <br /> James Culbertson, Pres. City of Lodi <br /> San Joaquin County <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Pimento] Stockton, Callfornla95201 City of Manteca <br /> City of Ripon <br /> Fern BuBbee 209/466-6781 City of Stockton <br /> Daniel L. Flores City of Tracy <br /> John D. Mast, M.D. <br /> William J. Wade Jog[ Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love flu <br /> Joaquin County <br /> Facility Name ��� ta- Ru 6bf-_ r- <br /> Address a TP Dr, n <br /> Date of Inspection aCP Inspector <br /> MONITORING ALTERNATIVE V5 <br /> t/ 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 /> z-<�Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified Com' dates. <br /> Precision test(s) must be performed by� ( d 6 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 /> ODaily inventory reconciliation must be started imnediately,_ with records maintained <br /> at the facility for review. <br /> 04 Document daily check of suction piping function starting immediate. <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 <br /> that <br /> exceeded allowable.* The first statement is due by <br /> Dispenser meter(s) must be calibrated by 0-� I with copy of <br /> certification or Weights and Measures sticker nufnber surmitted 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 /> EH 23 001 3/86 <br />