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avAnv Ur tnuattta <br />James Culbertson, Pres. <br />Patricia E. Vannuccl. Secy. <br />Anthoneit• Van Spronsen <br />Earl Plrnenlel <br />fern supbee <br />Daniel L. Flo(ea <br />John D. Most. M.D. <br />William J. Wade <br />Mary Anna Low <br />SAN JU," ")UIN LWAL HEALTH DISTRICT <br />1601 East Hazelton Avenue, P. O. Box 2009 <br />Stockton, Callfornla 95201- <br />209/46"781 <br />5201209/46&6781 <br />J091 Khanna, M.D., M.P.H.. District Health Officer <br />Facility Name a_n' n <br />Address <br />Date of Inspection So <br />MONITORING ALTERNATIVE 05 <br />k)C>u V— <br />SERVING <br />City of Lodi <br />San Joaquin County <br />City of Escalon <br />City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />Inspector (r� <br />U U <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 />L, -" <br />"'Daily operational check of suction piping function. <br />[--� Calibrated meters for inputs and withdrawals: <br />_!:�LWeights 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 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 />C3__1 Daily inventory reconciliation must be started immediately, with records maintained <br />at the facility for review. <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 variations that <br />exceeded allowable.* The first statement is due by __3_ —' <br />6. Dispenser meter(s) must be calibrated by 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 1 <br />