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BOAR <br /> James Cul TRUSTEES S"I JOAQUIN LOCAL HEALTH DIE �� �U SSERv/ifVQ <br /> James Culbertson, Pns. � .� � <br /> Patricia E. Vannuool, Secy, <br /> Anthonstle van Spronaen 1801 East Hazelton Avenue, P. O. Boz 2009 San J city of uLodi <br /> Eari Plmantel caquln County unty <br /> Fern augbes Stockton, California952o1 City ofEacalon <br /> Daniel L. Flores 209/488-8781 city of Manteca <br /> John D. Most, M.D. City of Ripon <br /> William J. Wade Clty of Stockton <br /> Jopl Khanna, M.D., M.P.M., District Health Officer City of Tracy <br /> Mary Anna Low San Joaquin County <br /> San Joaquin County <br /> Facility Name <br /> Address ;?— <br /> Date <br /> 2Date of Inspection 95ZgS— <br /> p �—� � Inspector (/v <br /> MONITORING ALTERNATIVE 95 <br /> Ann al precision test on tank(s) and piping. <br /> Daily inventory reconciliation with submission ofuarterl' <br /> compliance with allowable variation. q Y statement regarding Xa <br /> Pipeline leak detectors on pressurized piping. <br /> L_ua1yY operational check of suction piping function. <br /> V C/alibrated 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 !,j—101-9 <br /> this office within 30 days of the test. and results submitted to <br /> /2. Pipeline leak detectors must be installed on pressurized piping by <br /> UDaily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> 4. 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 ria g� <br /> Oexceeded allowable. * The first statement is due by �— l that <br /> Dispenser meter s) must be calibrated by �_ p <br /> copy of <br /> certification or Weights and Measures stickernumber �ub�tted tthishoffice. <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 1 <br />