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01 <br />BOARD OF TRUSTEES <br />James Culbertson, Pres. <br />Patricia E. Vannuccl, Sec'y. <br />Anthonette Van Spronsen <br />Earl Pimentel <br />Fern Bugbee <br />Daniel L. Flores <br />John D. Mast, M.D. <br />William J. Wade <br />Mary Anna Love <br />I <br />SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br />City of Lodi <br />1601 East Hazelton Avenue, P. 0. Box 2009 San Joaquin County <br />City of Escalon <br />Stockton, California 95201 City of Manteca <br />209/466-6781 City of Ripon <br />City of Stockton <br />City of Tracy <br />Jogi Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br />San Joaquin County <br />F a c i 1 i ty Name Y,(j'/D,(/ (91 e—, /Y & 1�^--- <br />Address 19/01 A�_ /� .v. in c lv wx / l<, 1A <br />Date of Inspection s <br />MONITORING ALTERNATIVE #5 <br />Inspector <br />V 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. <br />Daily operational check of suction piping function. <br />' Calibrated meters for inputs and withdrawals: <br />j -:"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 />/1J Precision test(s) must be performed by -9/2 and results submitted to <br />��- this office within 30 days of the test. <br />Pipeline leak detectors must be installed on pressurized piping by31 <br />t1 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 al.l owabl e. * The first statement is due by <br />Dispenser meter(s) must be calibrated by&4~ (, 'A 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 />