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BOARD Of TRUSTEES SAN J 1QUIN LOCAL HEALTH DISTRIC <br /> James Culberleon, Pres. ` SERVING <br /> Palricla E. Vannuccl, Secy. we' City of Lodi <br /> Anthonetl• Ven Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 Sen Joaquin county <br /> Earl lelmenlel Stockton, California 95201 city or Escolon <br /> Fern augbee City of Maniac." <br /> Daniel L. Flores 209/466-6781 City of Ripon <br /> John D:Mast. M.D. - City of Stockton <br /> William J. Wade Joci Khanna, M.D., M.P.H., Dlslricl Health Officer CRY of Tracy <br /> Mary Anna Love San Joaquin County <br /> San Joaquin County <br /> Facility Name r(4Ct <br /> Address Z/) <br /> Date of Inspection L— a.3—� 7 Inspector i/ (TGt/ Z <br /> MONITORING ALTERNATIVE 95 <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 I <br /> V 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 ,3 —/547 -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 /> i <br /> 4. 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 dates and vari ti s that <br /> exceeded allowable.* The first statement is due by — �j— <br /> b. ) Dispenser meter(s) must be calibrated by ���s — with copy of <br /> certification or Weights and Measures sticker number submltt d 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 I <br />