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BOARIJ OF TRUSTEES <br />James Culbertson, Pres. <br />Patricia E. Vannuccl, Secy <br />Anthonetle Van Spronsen <br />Earl Plmenlal <br />Fern Bu9bee <br />Daniel L. Flores <br />John D. Mast, M.D. <br />William J. Wade <br />Mary Anna Love <br />Facility Name <br />Address ",Z37Z 5 -5-,, /t/; <br />Date of Inspection 13—f -7 <br />MONITORING ALTERNATIVE #5 <br />Inspector �i✓ <br />V, /Annual precision test on tank(s) and piping. <br />l/ 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 />1.1 Precision test(s) must be performed by and results submitted to <br />this office within 30 days of the test. <br />.-4. Pipeline leak detectors must be installed on pressurized piping by <br />l� Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <br />i <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 variat'n that <br />exceeded allowable.* The first statement is due by jG% <br />a <br />06.Dispenser meter(s) must be calibrated by _ with copy of <br />certification or Weights and Measures sticker number sued tbrnitto 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 ?644(f) for <br />required actions. <br />3-86 UGT I <br />SAN494QUIN LOCAL HEALTH DISTRIP <br />SERVING <br />City of Lodi <br />1601 East Hazelton Avenue, P. 0. Box 2009 <br />San Joaquin County <br />City of Escalon <br />Stockton, Callfornia 95201 <br />City of Manteca <br />209/466-6781 <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />Jogl Khanna, M.D., M.P.H., District Health Officer <br />San Joaquin County <br />San Joaquin County <br />Address ",Z37Z 5 -5-,, /t/; <br />Date of Inspection 13—f -7 <br />MONITORING ALTERNATIVE #5 <br />Inspector �i✓ <br />V, /Annual precision test on tank(s) and piping. <br />l/ 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 />1.1 Precision test(s) must be performed by and results submitted to <br />this office within 30 days of the test. <br />.-4. Pipeline leak detectors must be installed on pressurized piping by <br />l� Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <br />i <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 variat'n that <br />exceeded allowable.* The first statement is due by jG% <br />a <br />06.Dispenser meter(s) must be calibrated by _ with copy of <br />certification or Weights and Measures sticker number sued tbrnitto 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 ?644(f) for <br />required actions. <br />3-86 UGT I <br />