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BOARD OF TRUSTEES SAN-,YJAQUIN LOCAL HEALTH DISTRtt;T SERVING <br /> James Culbertson, Pres. City of Lodi <br /> Patricia E. Vannuccl, Sac'y. P. O. Box 2009 San Joaquin County <br /> 0hMelts Van Wonsan Zfi01 fast Hazelton Avenue, City of Escaion <br /> 1PIrnental Stockton, Callfornla 95201 City of Manteca <br /> Fern Supbee 209/466-6781 City al Ripon <br /> Daniel L. Flores City of Stockton <br /> John 0. Mast, M.D. City of Tracy <br /> Wttilam J. Wada' Jogl Khanna, M.D., M.P.H., District Health Offlew San Joaquin County <br /> Mary Anna Lova San Joaquin County <br /> Facility Name G' C�C��rn1 <br /> Address D / <br /> Date of Inspection ZA62 Inspector <br /> MONITORING ALTERNATTYE #5 <br /> t"Annual precision test on 'tank(s) and piping. <br /> V Daily inventory reconciliation with submission of quarterly statement regarding <br /> compliance~ with allowable variation. <br /> l� Pipeline leak detectors on pressurized piping. <br /> "4ily operational check; of suction pipingfunction. <br /> L <br /> Calibrated meters for inputs and withdrawals: <br /> Weights and Measures sticker <br /> l'Certification by qualified repairman <br /> Implementation of this monitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> 1 Precision test(s) must be performed by -MY 7 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 /C1 <br /> Daily inventory reconciliation must be started immediately, with records maintained <br /> at the facility for review. <br /> Document daily check of suction piping function starting immediately. <br /> C5+ Submit quarterly statement to this office. that.allawabbe -variation-on�inventoryf— J <br /> - -- reconc-il-iation has-not 'been exceeded or a list of dates and yari iLQn5 that <br /> exceeded allowable.* The first statement is due by <br /> b Dispenser meter(s) must be calibrated by with copy of <br /> certification or Weights and Measures sticker n m er -submitted to this office. <br /> If the above compliance dates cannot be met, contact this office prior to the specified <br /> date. <br /> w If allowable daily inventory variation is exceeded, refer to Section 2644( f) for <br /> required actions. <br /> 3-86 UGT 1 <br />