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- BOARD of TRUSTEES- SA*AOUIN LOCAL HEALTH DIST - -- -- ----SERVIHD-- -_.. - <br /> James Culbertson, Pre&. City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 Eaat Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anlhonette Van Sproneen City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern 209/488-8781 City of Ripon <br /> Daniel <br /> L.L. Fi Flores City of Stockton <br /> John D. Mast, M.D. City ofTracy <br /> William J. Wade Joel Khanna, M.D., M.P.H., District Health Dillow San Joaquin County <br /> Mary Anna Low San Joaquin County <br /> Facility Name l ay'c (� C--I -C <br /> Address ���(�� ( �l�l= I bl-'(G2- 71 <br /> � (Ik <br /> Date of Inspection 9 Inspector vuE 'I-0-U I IVt <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 /> ti —. 1 ipeline leak detectors on pressurized piping. <br /> I/ 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 <br /> 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 K-1�___. <br /> 30 Daily inventory reconciliation must be started imined-iatejy, with records maintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediatell. <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 variations that <br /> exceeded allowable. * The first statement is due by Q 1S i55Q -__ --- <br /> Dispenser <br /> .Dispenser meter(s) must be calibrated by �b - ( I_, - 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 />