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BOARD OF TRUSTEES SAN `AQUIN LOCAL HEALTH DISTRI - SERVINo <br /> James Culbertson, Pre&. ► - `�+ City of Lodi <br /> Anthonsll•Van Spronean Vannuccl, seo'y. 1601 East Hazalton Avenue' P. 0. Box 2009 San Joaquin Count <br /> nlhonll <br /> Earl f lCity of Eacaion <br /> mentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D. Meal, M.O. City of Stockton <br /> Clly of Tracy <br /> William J. Wade JoDI Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Lova �J„„ f San Joaquin County <br /> Facil ity Name Lcyron 'V. 5. f� .� =r1 C . <br /> Address 103 W, or <br /> L'�• <br /> Date of Inspection 9-,2- 2 Inspector do a a�— <br /> MONITORING ALTERNATIVE J5 <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 /> POA Pipeline leak detectors pn pressurized piping. <br /> ✓Daily operational check of suction piping function. <br /> ✓Calibrated meters for inputs and withdrawals: <br /> i/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 /> Precision test(s) must be performed by lf—, S_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 /> Daily inventory reconciliation must be started ilrmediately, with records maintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediately. <br /> C5) 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 <br /> Dispenser meter(s) must be calibrated by �w d� c(a{e CRI with copy of <br /> certification or Weights and Measures sticker nu ler submitted to this office. <br /> If the above compliance dates cannot be met, contact this office prior to the specified <br /> date. <br /> a If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions. <br /> 3-86 UGT 1 <br />