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BOARD OF TRUSTEES SAi"OAQUIN LOCAL HEALTH DISTs-,CT SERVING <br /> James Culbertson, Pre$. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jog[ Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Name MocjeS-6 rgljnv C6 <br /> Address y.2 2.1 E. Mci riRose, <br /> Date of Inspection / 6 7 -Ur,, P�onG Inspector C ,t/ .'f- <br /> MONITORING ALTERNATIVE ,i5 <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 /> .r $Pipeline leak detectors on pressurized piping. <br /> t/ Daily operational check of suction piping function. <br /> _{Calibrated meters for inputs and withdrawals: <br /> er- p, A or. b _Weights and Measures sticker <br /> 5—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 /;,&4g-es 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 el/A <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 ////90 <br /> 6. 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 /> EH 23 001 3/86 <br />