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Patriots E. Vannuool, Secy. <br />AMINwMle Van apronaan <br />Earl Plmanlal <br />Fant augt e" <br />Daniel L. florea <br />John D. Mast, M.D. <br />William J. Wade <br />Mary Anna Low <br />facility Name <br />Address IAZI D C <br />Date of Inspection 3 <br />City of Lodi <br />14ast Hazelton Avenue, P. 0. Box 2009 San Joaquin <br />county <br />Stockton, Califom1a 95201 CNyel Mantes <br />209/4888781 Gaol Ripon <br />City of Stockton <br />Gly of Tracy <br />Joel Khanna, M.D.. M.P.N.. Dist" Health Officer San Joaquin County <br />San Joaquin County <br />Cr <br />Inspector <br />MONITORING ALTERNATIVE /5 /, 600 <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 />V Calibrated meters for inputs and withdrawals: <br />Weights and Measures sticker <br />L,- Certification by qualified repairman <br />Implementation of this monitoring alternative requires that the following CIRCLED items <br />be completed by the specified dates. (� <br />10 Precision test(s) must be performed by 5 / 0 and results submitted to <br />Pipeline leak detectors must be installed on pressurized piping by / �1 <br />Daily inventory reconciliation must be started immediately, with records maintained <br />l / at the facility for review. <br />Document daily check of suction piping function starting immediately. <br />5.' Submit Quarterly statement to this office that allowable variation on inventory <br />reconciliation has not been exceeded or a list of datesv iati9ns th t <br />exceeded allowable.* The first statement is du by _ _ S <br />Dispenser meter(s) must be calibrated by� with copy of <br />certification or Weights and Measures stickeriiiin tuber 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 />