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BOARD OF TRUSTEES SA JOAQUIN LOCAL HEALTH DISTRI6T SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escelon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fere Bupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne Love San Joaquin County <br /> Facility Name6 .G_OG-e <br /> Address 6' /or �e- "�-oc SY Z ,01 o p <br /> Date of Inspection Inspector ,�i Ci >� in ot�C <br /> MONITORING ALTERNATIVE #5 /-/2,1000 �ca .� /-/0/GOO crz.ea.c.I <br /> L/ Annual precision test on tank(s) and piping. <br /> Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> Y_kPipeline leak detectors on pressurized piping. <br /> 1�-'Daily operational check of suction piping function. <br /> (/Calibrated meters for inputs and withdrawals: <br /> 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 /> W. Precision test(s) must be performed by �_/-/4 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 N <br /> ODaily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediately. <br /> Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dateynd arp. ions that <br /> exceeded allowable.* The first statement is due by <br /> Dispenser meter(s) must be calibrated by �_-Z- with copy of <br /> v 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 I <br />