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DO:,RC/ STEE8 SA OAQUIN LOCAL HEALTH DIST ;T SERVING <br /> James C�Iber+_)n, Pre$. City of Lodi <br /> Patricia !:. Vannuccl, Secy. 1601 East Hazelton Avenue, P. O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Pimentel 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. 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 Anne Love San Joaquin County <br /> Facility Name <br /> Address V(1Q <br /> Date of Inspection ,/ f/11jj '- / S. <br /> MONITORING ALTERNATIVE #5 <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.f(t-n.toT ?ytZU-41a IXl574aF 6 <br /> Daily operational check of suction piping function. <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker/,cpU �`�It�_U��l <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 /> li. Precision test(s) must be performed by /�/(tii�, 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 /> (3 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 <br /> 6. Dispenser meter(s) must be calibrated by f(g2 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-£36 UGT l <br />