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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> James Culbertson, Pres. <br /> City of Lodi <br /> Pata E. V nuccl, sec y. 1601 East Hazeox 20 <br /> Hazelton Avenue, P. 0. B09 San Joaquin County <br /> Anthohonetta Van Spronaen City of Escalon <br /> Earl Plmentel Stockton, Callfornla 95201 City of Manteca <br /> Fern Bupbee Cit of Ripon <br /> Daniel L. Flores 209/466-6781 city it Stockton <br /> John D. Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.O., M.P.M., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Facility Name - <br /> Address c� <br /> Date of Inspection Inspector <br /> i <br /> Tank(s)# _2 <br /> MONITORING ALTERNATIVE #8: Inventory Reconciliation <br /> Z/Qualifying status: Governmental agency <br /> Small business <br /> Written contract for removal or replacement <br /> ;/ Annual precision test on tank(s) and piping. <br /> �aily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variations. <br /> Daily operational check of suction piping function. <br /> kv 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 /> I . , Precision test(s) must be performed by nd results submitted to this <br /> office within 30 days of the test. <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> L3� Submit quarterly 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 /— %- � -72- <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 />