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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DIST CI SERVING <br />r City of Lodi <br />James Culbertson, Pre$. <br />cy. San Joaquin of County <br />Patricia E. Vannuccl, Se <br />1601 East Hazelton Avenue, P. O. Box 2009 City of Escalon <br />Anthonstte Ven Spronsen <br />Earl Plmentel Stockton, Callfornla 95201 City of Manteca <br />City of Ripon <br />Fern Sup bee <br />209/466-6781 City of Stockton <br />Daniel L. Flores City of Tracy <br />John D. Mast, M.D. <br />William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer Sen Joaquin County <br />Mary Anne Love /+ p San Joaquin County <br />Facility Name <br />Address 7' <br />Date of Inspection I Inspector <br />Tank(S)# <br />MONITORING ALTERNATIVE 8: Inventory Reconciliation <br />Qualifying status: L/60vernmental agency <br />Small business <br />Written contract for removal.or replacement <br />4�/Annual precision test on tank(s) and piping. <br />✓Daily inventory reconciliation with submission of quarterly statement regarding <br />compliance with allowable variations. <br />t/ Daily operational check of suction piping function. <br />Calibrated meters for inputs and withdrawals: <br />_fGtJeights 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. 1 (� <br />17 Precision test(s) must be performed by and results submitted to this <br />office within 30 days of the test. <br />Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <br />03- Submit quarterly statement to this office that allowable variations on.inventory <br />reconciliation have not been exceeded or a list of dates d iations that <br />exceeded allowable.* The first statement is due by /S <br />If the above compliance dates cannot be met, contact this office prior to the specified <br />date. <br />*If allowable inventory variations are exceeded, refer to Section 2644(f) for required <br />actions. <br />