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SOARD OF TRUSTEES <br />J&nm Culbertson, Pres. <br />PatriciaE. Vannuccl. <br />Ant to Van Spronsen <br />Earl Pimentel <br />Fern Sugbee <br />Daniel L. Flores <br />John D. Mast, M.D. <br />William J. Wads <br />Mary Anna Love <br />Facility Name <br />Address <br />=Wm, Mw <br />:0 • :.x 2rr9 <br />Stockton, California r <br />2(tLT/46"781 <br />Jogl Khanna. M.D.• M.P.H.. District Health Officer <br />M <br />SERVING <br />Chy of Lodl <br />San Joaquin County <br />City of Escalon <br />City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />Date of Inspection Inspector rl Z) <br />MONITORING ALTERNATIVE #5 <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 />L__� Pipeline leak detectors on pressurized piping. <br />Daily operational check of suction piping function. <br />calibrated meters for inputs and withdrawals: <br />L__/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 <br />this office within 30 days of the test. <br />and 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 that <br />exceeded allowable.* The first statement is due by 4 _/15 - <br />6. Dispenser meters) 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 <br />required actions. <br />3-86 UGT 1 <br />is exceeded, refer to Section 2644(f) for <br />