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aOARD or TRUSTEE& SANUIN LOCAL HEALTH DISTRI SERVING <br /> Janes Culbertson. Pre$. IV CltyofLodf <br /> n<honaf <br /> dcla <br /> Ala Van Sprone.n <br /> ralhon E. Vannuccl, Secy. 1601 East Hazelton Avenue. P. 0. Box 2009 San Joaquin Count Earl pta"ntaf Stockton. CatilomGtr of Escafon <br /> la 95201" Gtr of &Mace <br /> Fl <br /> Daniel L. Florae <br /> Darn euot2091486 761 City of Ripon <br /> City of Stockton <br /> John D. Mut. M.D. City of Tracy <br /> William J. Wade Jool Khanna. M.D.. M.P.H.. District Haallh Officer San Joaquin County <br /> Mary Anna Low Son JoaauInCounty <br /> E a c i l i ty Name Pt-N r <br /> Address <br /> Date of Inspection �� _ Inspector <br /> MONITORING ALTERNATIVE wry <br /> VOPAnnual precision test on tank(s) andi in . <br /> P P 4 <br /> / ily-inventory (reconciliation with submission of quarterly statement 'regarding <br /> ' f compliance with allowable variation. <br /> V Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> zcalibrated meters r <br /> Weiinputs 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 /> completed by the specified dates. <br /> 1 Precision test(s) must be performed by1-36 -8-7and results submitted to <br /> this office within 30 days of the test. <br /> ` 2 Pipeline leak detectors must be installed on pressurized piping b <br /> p g y 7 <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 /> C-5f Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variati ns that <br /> exceeded allowable.* The first statement is due by <br /> 6 Dispenser meter(s) must be calibrated by _ 8' with. copy of <br /> certification or heights and Measures sticker number submi ted to this office. <br /> If the above compliance dates cannot be met . contact this office prior to the specified <br /> date. I , <br /> If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions. <br /> 3-86 11r.T t <br />