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aOARD OF TRUSTEES SAN Jr QUIN LOCAL HEALTH DISTRIC SERVING <br /> James, Culbertson, Pres,. r City of Lodi <br /> Patricia E. Vannucci. Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anlhonetle Van Spronsen City of Escalon <br /> Eon Pimenisl Stockton, California 95201 City of Manteca <br /> Fern Sugbee 209/466-6781 City of Ripon <br /> Daniel L. Flores _ City of Stockton <br /> John 0. Most. 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 Low San Joaquin County <br /> Facility Name -e_S — anA <br /> Address [ (); 0 aA ot-Lx* I <br /> Date of Inspection [-011 — �� Inspector �"-ga.-e + CA0 f6 <br /> MONITORING ALTERNATIVE #5 <br /> I/ Annual precision test on tank(s) and piping. <br /> wily 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 <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 3— o2y — $ and results submitted to <br /> this office within 30 days of the test. I <br /> 2. Pipeline leak detectors must be installed on pressurized piping by 4 -� <br /> Daily inventory reconciliation must be started innediately, 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 vari tions hat <br /> exceeded allowable.* The first statement is due by —7— M I—W <br /> Dispenser meter(s) must be calibrated by 3 — iS —7s —7 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 I <br /> a <br />