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SOARO Of TRUSTEES SAN JC )UIN LOCAL HEALTH DISTRIC— SERVING <br /> Jamas Culbertson. Pros. - City of LOCI <br /> Patricia vannuccl, sac'y. 1601 East Hazelton Avenue P. O. Box 2009 San Joaquin Count <br /> A Mhonottfls Van Spronsae ' -• <br /> City of Eseaion <br /> Fern Sup bee <br /> Ear Plmantsl � / Stockton, Californiaali95201' City of Manteca <br /> Dani209/466-6781 City of Ripon <br /> John D. <br /> Flores John D. Meat, M.D. City of Stockton <br /> City of Tracy <br /> William J. Wada ,L Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love ! ^- �(— <br /> r San Joaquin County <br /> Facility Name SiL —TQ Ucl< t 6�— <br /> Address �(G ��) , MIN 1 Ii-E W 5 Ce'>: fs z3/ <br /> Date of Inspection 4/Z/ Inspector <br /> MONITORING ALTERNATIVE 55 <br /> Annual precision test on tank(s) and piping. <br /> y Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> Pipeline leak detectors on pressurized piping. <br /> —7Daily operational check of suction piping function. <br /> V/ Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> V Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be ,completed by the specified dates. <br /> I Precision test(s) must be performed by 2" 3G—8 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 <br /> (Vat <br /> inventory reconciliation must be started immediately, with records maintained <br /> ( at the facility for review. <br /> 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 Z /— cam' <br /> Dispenser meter(s) roust 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 />