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BOARD Of TRUSTEES SAN '-1AQUIN LWAL HEALTH UIS I Hi' SERVING <br /> James Culbertson, Pres. . City of Lodi <br /> Patrkla E. Vannuocl, Sec'y. . O. Box 20M San Joaquin County <br /> ne <br /> Anthotte Van Spronsen 1607 East Hazelton Avenue, PCity of Escalon <br /> Eari Pimentel Stockton, California 85201 city of Manteca <br /> Fern Bupbee 208/466781 City of Ripon <br /> Daniel L. Flores City of Stockton <br /> John D. Mast. 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 Low San Joaquin County <br /> Faci 11 ty Name <br /> Address �� a -�o f I�tom i re e/l �54b <br /> Date of Inspection - 72 - g -7 Inspector n <br /> MONITORING ALTERNATIVE #5 <br /> L,�Annual precision test on tank(s) and piping. <br /> ✓Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance with allowable variation. <br /> t_�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 /> Precision test(s) must be performed by and results submitted o <br /> this office within 30 days of the test. a v' SU r., ,-1- 9 S u - - <br /> J <br /> 2. Pipeline leak detectors must be installed on pressurized piping by <br /> 0 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 - S _ <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 />