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BOARD OF TRUSTEES SAN WQUIN LOCAL HEALTH DISTRItj SERVING <br /> James Culbertson, Pres. City of LodI <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. 0. Box 2009 San Joaquin county <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, California 95201 city of Manteca <br /> Fern Bubee <br /> G 209/466-6781 City of Ripon <br /> Daniel L. Flores _ City of$tockton <br /> John D. Mast, M.D. - City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anne Love <br /> San Joaquin County <br /> Facility Name lf� 61,41 -Z ,,e§(11Au //2l 5. <br /> Address Lr 73 LpLlrniS /Qp( , STK <br /> Date of Inspection 8 _Inspector � �t7riND�� <br /> MONITORING ALTERNATIVE J5 /Z1000q s� - B 000 a� ��� !flAlKS <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 /> V Pipeline leak detectors on pressurized piping. <br /> Daily operational check of suction piping function. <br /> ✓Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> V Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. (l <br /> ( I .) Precision test(s) must be performed by 7 -/ 5 - ? and results submitted to <br /> this office within 30 days of the test. <br /> QPipeline leak detectors must be installed on pressurized piping by <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> 40 Document daily check of suction piping function starting immediately. <br /> 50 Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates an vacations that <br /> exceeded allowable.* The first statement is due by <br /> Dispenser meter(s) 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 is exceeded, refer to Section 2644( f) for <br /> required actions . <br /> 3-b6 UGT 1 <br />