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•BOARD'OF TRUSTEESSAI )AQUIN LOCAL HEALTH DISTF i" X114 , sERviNt) <br /> James Culbertson, Pre&. ' a City of Lodi <br /> Patricia E. Vannuccl, Secy. 1601 East Hazelton Avenue P. O. Box San.,�oaquln County <br /> Anthonette Van Spronsen City of Escalon <br /> Earl Plmentel Stockton, California 95201 ��;ir�Y 1 ip,,;"' City of Manteca <br /> Fern Bugbee 209/466-6781 City of Ripon <br /> Daniel L. Flores ENVIROMEtiTAL HEALTHY 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 FERMIT/SERVICfSSn Joaquin County <br /> Mary Anna Love San Joaquin County <br /> Fac i 1 i ty Name �L--xc <br /> r <br /> Address <br /> Date of Inspection _ Inspectora1�/�U <br /> MONITORING ALTERNATIVE #5 <br /> V---A'nnual precision test on tank(s) and piping. <br /> i,/Daily inventory reconciliation with submission of quarterly statement regarding <br /> /compliance with allowable variation. <br /> V Pipeline leak detectors on pressurized piping.CF�-tor Wim:-�Y W�7, �-6) <br /> Daily operational check of suction piping function. <br /> calibrated meters for inputs and withdrawals: I <br /> L// Weights and Measures sticker�Faf/ a`� -�G�J <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 /> 61). Precision test(s) must be performed by �� and results submitted to <br /> this office within 30 days of the test. <br /> Pipeline leak detectors must be installed on pressurized piping by 5-1( <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 /> Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and v riat' ns that <br /> exceeded allowable.* The first statement is due by ( ( � �� 7 <br /> 6. Dispenser meter(s) must be calibrated by -, (((o (�) 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 I <br />