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80AND OF TRUSTEES SAN#AQUIN LOCAL HEALTH DISTRI# <br /> James Culbertson, Pres. SERVING <br /> Patricia E. Vannuccl, Secy. City of Lodi <br /> Anthonette Van Spronsen 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Ead Plmentel Stockton, California 95201 City of Escalon <br /> Fern Bupbee City of Manteca <br /> Daniel L. Flores 209/466-6781 City o1 Ripon <br /> John D. Meat, M.D. <br /> City Of Stockton _ <br /> William J. Wads Jopl Khanna, M.D., M.P.H., District Health OfficerCltyof Tracy <br /> Mary Anna Love San Joaquin County <br /> Sen Joaquin County <br /> Facility Name Lc�-�✓ � ��Qcr /� <br /> Address (16VO <br /> Date of Inspection Inspecttoo'r.F��a <br /> MONITORING ALTERNATIVE 36 ///?GtU� cico <br /> ✓ Annual precision test on tank(s) and piping. <br /> L-/Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> N A Pipeline leak detectors on pressurized piping. <br /> V 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 /> C1 Precision test(s) must be performed byand results submitted to <br /> this office within 30 days of the test. <br /> 2. Pipeline leak detectors must be installed on pressurized piping by AJIA <br /> l Daily inventory reconciliation must be started imnediately, with records maintained <br /> at the facility for review. <br /> 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 _&�ICY- /S /gR? <br /> Dispenser meter(s) must be calibrated by / �7 with copy of <br /> certification or Weights and Measures sticker ntsmt5er 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 />