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60ARD OF TRUSTEES SAN J AQUIN LOCAL HEALTH iD1STRO 3 0 r SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Sec'y. 1601 East Hazelton Avenue, P. 0. Box 2009 San Joaquin County <br /> Anthonatte Van Spronsen City of Eacalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bugbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Most, M.O. City of Tracy <br /> William J. Wade Jogl Khanna, M.D., M.P.H.. District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facil ity Name <br /> Address 7AV.. -�df",v P S7-) <br /> Date of Inspection Zy- �' Inspector <br /> MONITORING ALTERNATIVE #5 <br /> Annual precision test on tank(s) and piping. <br /> I//Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> Pipeline -leak detectors on pressurized piping. <br /> k'Daily operational check of suction piping function.. <br /> ✓' Calibrated meters for inputs and withdrawals: <br /> , Weights and Measures sticker <br /> I/ 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 -/. 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 <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> 0 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 variations that <br /> exceeded allowable.* The first statement is due by 3- 3o - 919' <br /> 6. Dispenser meter(s) must be calibrated by -lam- 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 /> 3-86 UGT 1 <br />