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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> At Crow,Pres, SERVING <br /> Earl Pimenief,wce Pres. 1601 East Hazelton Avenue San Jouqum Courtly <br /> TommyJoyca,sec'y. StocktonCalifornia 952Q5 City oI Manteca <br /> Jame ,s F.Culbernson City of Escalon <br /> John 0.Mast,MZ. JOGI KHANNA, M.D., M.P.H., DISTRICT HEALTH OFFICER City of Lodi <br /> Virginia Mathews City of Tracy <br /> Thomas Schubert D.Y.M. 209/168-3420 City of Ripon <br /> Daphne Shaw San Joaquin Cuunty <br /> Harvey Williams,Ph.D. City of Stockton <br /> San Jaaquir,County <br /> Facility Name f`- o ze-IS b rr l <br /> Address <br /> Date of V J Inspector VI <br /> . � MONITORING ALTERNATIVE 5 <br /> ✓ Annualrecisio <br /> p n test an tank (s) and piping. <br /> _,� Daily inventory reconciliation with submission of quarterly <br /> statement regarding 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 /> Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the <br /> following CIRCLED items be completed by the specified dates. <br /> 1• Precision test (s) must be <br /> performed by j and <br /> results submitted t <br /> • this office within 30ay of the test. <br /> 2 • Pipeline leak detectors must be installed on pressurized <br /> Piping by <br /> Daily inventory reconciliation must be started immediately, <br /> with records maintained at the facility for review. <br /> Document daily check of suction Piping function starting <br /> immediately, g <br /> Submit quarterly statement to this office that allowable <br /> variation on inventory reconciliation has not been exceeded <br /> or a list of dates and variations that exceeded allowable. <br /> The first statement is due byc, <br /> Dis eraser l � � ��' <br /> P meters) must be calibrated by I Jyc with a <br /> copy of certification or Weights and Measur Sticker number <br /> submitted to this office. <br /> If the above compliance dates cannot be met, contact this office <br /> prior to the specified date. <br /> * If allowable daily inventory variation is exceeded, refer to <br /> Section 2644 (f) for required actions . <br /> EH 23 001 4/89 <br />