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BOARO OF TRUSTEES SAN ALIN LOCAL HEALTH DISTRICT* SERVING <br /> James Culbertson, Pros. City of Lodi <br /> Patricia E. Vennucct. Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonelle Van Spronaen City of Escalon <br /> Earl Pimenlei Stockton, Callfornla 95201 City of Mentscs <br /> Fern Bupbee 209/466-6781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Meet. M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love / San Joaquin County <br /> Fac 11 i ty Name Q/ i2 f 1 lCt f—,r— Ca4- (Al S�1 <br /> Address Lf CZ() <br /> 7 0.5e4 --rl <' <br /> Date of Inspection Inspector ZLi r�Q ( t�1 <br /> Tank(s)# �— <br /> MONITORING ALTERNATIVE H8: Inventory Reconciliation <br /> `Qualifying status: Governmental agency <br /> t/Small business <br /> Written contract for rernoval .or replacement <br /> L---�Annual precision test on tank(s) and piping. <br /> L,"Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variations: <br /> Daily operational check of suction piping function. <br /> L—ta-librated 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 /> G-) Precision test(s) must be performed byand results submitted to this <br /> office within 30 days of the test. <br /> �2� Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> D3Submitquarterly statement to this office that allowable variations on inventory <br /> reconciliation have not been exceeded or a list of dates and variations that <br /> exceeded allowable.* The first statement is due by <br /> If the above compliance dates cannot be met , contact this office prior to the specified <br /> date. <br /> *If allowable inventory variations are exceeded, refer to Section 2644(f) for required <br /> actions . <br /> 5/86 <br />