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BOARD OF TRUSTEES SAN AQUIN LOCAL HEALTH DISTRICT SERVING <br />James Culbertson, Pres. City of Lodi <br />Anthonette Van Spronsen <br />Patricia Vannucci, Secy. 1601 East Haze ° Hazelton Avenue P. O. Box 2009 San Joaquin County <br />tt <br />Earl Pimentel Stockton, California 95201 City of EscalonCity of Manteca <br />Fern eupb 209/466-6781 City of Ripon <br />Daniel L. Flores <br />John D. Mast, M.D. City of StocktonCity of Tracy <br />William J. Wade Jopl Khanna, M.O., M.P.H., District Health Officer San Joaquin County <br />Mary Anna Love San Joaquin County <br />Facility Name f R- <br />Address-- ! Ili — l �- <br />Date of Inspection '7 Inspector <br />MONITORI G ALTERNATIVE i#5 <br />_Annual precision test on tank(s) and piping. <br />Daily inventory reconciliation with submission of quarterly statementre ardin <br />compliance with allowable variation. g g <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 -3 8 7 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 />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. ubmit 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 _3 p <br />U6. 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 />