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BOARD OF TRUSTEES <br />SANWOAQUIN LOCAL HEALTH DIST -T <br />SERVING <br />City of <br />James Culbertson, Pres. <br />San Joaquin County <br />Patricia E. Vannuccl, Secy. <br />1601 East Hazelton Avenue, P. O. Box 2009 <br />City of Escalon <br />Anlhonette Van Spronsen <br />Stockton, California 95201 <br />City of Manteca <br />Earl Pimeniel <br />City of Ripon <br />Fern Bugbee <br />209/466-6781 <br />City of Stockton <br />Daniel L. Flores <br />City of Tracy <br />John D. Mast, M.D. <br />Jogl Khanna, M.D., M.P.H., District Health Officer <br />San Joaquin County <br />William J. Wade <br />- <br />San Joaquin County <br />Mary Anna Love <br />Facility Name --__--_- <br />Address �---- <br />Date of Inspection ,�fiZ/i�� Inspector'a�_(l <br />MONITORING ALTERNATIVE ;15 SOOOG�f�L fA�1K <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. <br />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 />Precision test(s) must be performed by 7�3/ lr'G 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 AI <br />Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <br />J.04 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 dates and y���ions that <br />exceeded allowable.* The first statement is due b / JC <br />Dispenser meter(s) must be calibrated by 7/11e6 with copy of <br />Div 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 <br />required actions. <br />3-86 <br />is exceeded, refer to Section 2644(f) for <br />All?ell 41e� <br />