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BOARD OF TRUSTEES -S/,_;JOAQUIN LOCAL HEALTH DlST�T V1} TSEFtviNa " <br /> Jimae Cult»rtson, Pres. <br /> City of l`oal. <br /> t hon E. V an Sprone*n nnocl, s <br /> Anthonetl• Van 1601 East Hazelton Avenue. f. O. Box 20 3 San J6aquln County <br /> en = <br /> cafon <br /> Eut Ptmentel Stockton Californla 95201 (tyCRYf Eanteca <br /> Clly of Manteca• �, <br /> Fern Sugbos . <br /> 209/468-8781 city or Ripon <br /> Danlel L. Flores , City or Stockton <br /> John D, Mast, M.D. City of Tracy <br /> William J. Wade Jogl Khanna. M.D.. M.P.H.. Dlstdct Health Offlcar San Joaquin County <br /> Mary Anna Low t , San Joaquin County <br /> C OLD <br /> Facility Name _ j <br /> Address Po'g--T <br /> 2 •�� (�� jj <br /> , 1 <br /> Date of Inspection 3-•- —� - Inspector T <br /> `M4NIT0 ING •ALTERNATHE ;15 <br /> .. <br /> Annual precision test on tank(s) and piping. _ 1 <br /> D fly inventory reconciliation with submission of quarterly statement regarding <br /> ompliance with allowable variation. i <br /> s <br /> Pipeline '.leak detecto-rs on pressurized piping. <br /> Daily operational check of suction .piping function. ' <br /> /Calibrated meters for inputs and withdrawals: l <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 /> 1 . Precision tests must be t <br /> test(s) performed by y" 2.� and results submitted to <br /> this office within 30 days of the test.(2) _ <br /> Pipeline leak detectors must be installed. on pressurized piping by <br /> Daily inventory reconciliation must be started ininediaately, with reco rds maintained <br /> t the facility for review. 4 <br /> 4 Document daily check of suction piping function starting immediately. 1 <br /> Submit: quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variat' that <br /> exceeded allowable.* The first statement is due by - � •� <br /> 0 Dispenser meter(s) must be calibrated -by 5� with co of <br /> certification or Weights and Measures sticker number submitted to this office. <br /> I t <br /> f 'the above compliance dates cannot be met, contact this office prior to the specified <br /> date. - r _ <br /> If allowable daily inventory 'varlation is exceeded, refer to Section 2644( f) for <br /> i required actions. <br /> 1'3-86 UGT 1 <br /> j <br /> 1+ - <br />