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LJARD OF TRUSTEES S ,AQUIN LOCAL HEALTH DIST ' SERVING <br /> James Culbertson, Pros. _ City of Lodi <br /> Patricia E. Vannuocl, Secy. 1801 East Hazelton Avenue, P. 0. Box 2009 San Joaquin county <br /> AnlSonetto V&n Spronsen City of Escalon <br /> Earl Plmentel Stockton, Callfornia 95201 City of Manteca <br /> Fem Bugles 209/488 8781 City of Ripon <br /> Daniel L. Flores Clty of Stockton <br /> John 0, Most, M.D. City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Low San Joaquin County <br /> Facility Name �y /Vl Alit/ze,S 7— <br /> Address <br /> Address e4') 7y <br /> Date of Inspection /q�- 7 Inspector lill,i <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 /> Pipeline leak detectors on pressurized piping. nruI1,'Ie, "`rN6S,'11057416 OF,)) <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker{ lF' OV'Ff? aYirS. ULA <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 /> Precision test(s) must be performed by %J �� and results submitted to <br /> this office within 30 days of the test. <br /> 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 Lle <br /> 6. Dispenser meter(s) must be calibrated by "//, -7 fIr, 7 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 />