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BbARD OF TRUSTEES SAOOAQUiN LOCAL HEALTH DIS 1 I SERVING <br /> ' James Culbertson, Pres. City of Loch <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenge, P. U. Box 2009 San Joaquin County <br /> Anthoneite Van Spronsen City of Escalon <br /> Earl Pimentel Stockton, Callfornia 95201 City of Manteca <br /> Fern Bugbee 209/466-6781 City of Rlpon <br /> Daniel L. Flores City of Stockton <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 Anna Love San Joaquin County <br /> Faci 1 i ty Name 411?7/-r' <br /> Address <br /> Date of Inspection ^------ Inspector <br /> MONITORING ALTERNATIVE #5 <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 /> f Pipeline leak detectors on pressurized pipingr. Cl'NOT <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> f <br /> U' Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> lj. Precision test(s) must be performed by ' and results submitted to <br /> this office within 34 days of the test. <br /> `. Pipeline leak detectors must be installed on pressurized piping by ;lt <br /> 13.. Daily 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 variations that <br /> exceeded allowable.* The first statement is due by j <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 /> 3-86 U(-,T 1 <br />