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0!JAr%u ur tKUS1t:E4 SAN AQUIN LOCAL HEALTH DISTRSERVING <br /> James Culbertson, Pres. I City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 l=ath Hazelton Avenue P. O. BOX 20W San Joaquin County <br /> Anlhonstle Van Spronsen ' City of Escafon <br /> Earl Pimenlei Stockton, California 85201 city of Manteca <br /> Fern Rugbee 209/466-6781 City of Ripon <br /> City Daniel L. Flores f <br /> _ y of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H., District Health officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Name Pn r- <br /> Address 116I-- <br /> Dateofof Inspection ins ector <br /> MONITORING ALTERNATIVE Y5 <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 /> I//Daily operational check of suction piping function. 'Ta. " I��� 3) <br /> kf Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> L,`fCertification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> Precision test(s) must be performed by and results submitted to <br /> this office within 30 days of the test. <br /> C2J Pipeline leak detectors must be installed on pressurized piping by - ��-��, <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> �r at the facility for review. <br /> f4. ) 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 -7 <br /> 11" 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. <br /> If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions . <br /> 3-fab t11-.T I <br />