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130AKU Ur Ahu>ICCQ gflw wr wlI wv, .._ . ..-. .... . . . . .. <br /> Lodi <br /> James Culbertson, Pres. City of County <br /> Patricia E. Vannuccl, Secy. 196 East Hazelton Avenue, P. O. Box A San City o Escaloy <br /> Anthonette Van Spronsen City of Escalon <br /> Stockton, California 95201 City of Manteca <br /> Earl Pimgntel City of.Rlpon <br /> Fern Bupbee 209/466-6781 City of Stocktonr- <br /> Daniel L. Flores City of Tracy <br /> John D. Mast, M.D. <br /> William J. Wade Jopi Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Namet> <br /> Address <br /> Date of Inspection Inspector /111/ �� /P" �> <br /> MONITORING ALTERNATIVE ;#5 <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 /> 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 following CIRCLED items <br /> be completed by the specified dates. <br /> 1.. Precision test(s) must be performed by and results submitted to <br /> J this office within 30 days of the test. - <br /> `2 Pipeline leak detectors must be installed on pressurized piping by r , . <br /> 3. Daily 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 /> /61 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 /> 3-86 . UGT 1 <br />