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BOARD OF TRUSTEES SAN JO-AQUIN LWAL HLALI H UIS I HI(— SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. VQnnucci, Secy. 1601 East Hazelton".�vfj e,'P.�O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, California 95201 City of Manteca <br /> Fern Bupbee 209/466-6781 city of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Most, M.D. City of Tracy <br /> William J. Wade Joel Khanna, M.D.. M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love -� San Joaquin County <br /> Facility Name <br /> Address /(J, 0-n <br /> Date of Inspection Inspector / d \ <br /> MONITORING ALTERNATIVE #5 <br /> t/ Annual precision test on tank(s) and piping. <br /> aily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> Pipeline leak detectors on pressurized piping. <br /> 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 /> l� Precision test(s) must be performed by S' 7 and results submitted to <br /> —'l this office within 30 days of the test. �; r -�,J) n\ ) 61 + <br /> 2. Pipeline leak detectors must be installed on pressurized piping by <br /> /\ 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 /> \/ Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and varia ons that <br /> exceeded allowable. * The first statement is due by <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 /> 3-80 UGT 1 <br />