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BOARD OF TRUSTEES <br />J Culbertson, Pros. JOAQUIN LOCAL HEALTH ® T SERVING <br />PatriciaE. Yannucol, 'y. City of Lodi <br />Anthonotts, van Spronson 1601 East Hazelton Avenue, P. O. Box 2oog San Joaquin County <br />Eat Pimental Stockton, California 952ol City of Escaton <br />Fern Bullbeo <br />Daniel L. Flores city of Manteca <br />209/ P� City of Ripon <br />John D. Mast, M.D. City of Stockton <br />William J. Wads Jo®I Khanna, M.D., M.P.N., District Health Officer City Of Tracy <br />Mary Anna Love San Joaquin County <br />San Joaquin County <br />Facility Name <br />Address <br />Date of Inspection''' .i� "Inspect <br />MONITORING ALTERNATIVE #5 <br />—7Annual precision test on <br />.. tank(s) and piping. <br />k Daily inventory reconciliation with submission of quarterly statement 're and X: <br />mpliance with allowable variation. 9 ing <br />Pipeline leak detectors on pressurized piping. <br />]E <br />D ily operational check of suction piping function. <br />Calibrated meters for inputs and withdrawals: <br />We ghts and Measures sticker <br />Certification by qualified repairman <br />Implementation of this monitoring alters ive requires that the followin <br />be completed by the specified dates. �. g CIRCLED items <br />1 Precision test(s) must be performed b <br />this office within 30 days of the testand results submitted to <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. Submit quarterly statement to this office that allowable variation on inventory <br />reconciliation has not been exceeded or a list of dates and variations hat <br />exceeded allowable.* The first statement is due by <br />6 Dispenser meter(s) must be calibrated by _� <br />certification or Weights and Measures sticopy of <br />cker number subm tt ei d to thiswithoffiice. <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 1 104 Mte � 112— 7- <br />