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•OAR® of TRUSTEES SAN J ' UIN LOCAL Hp.ALTH DISTRICT $ &ER"No <br />J®ewee Culbwl•on. Pe••. <br />PolMieta E. vannuccl. S•c'y. San Joaquin City o/ Lodi <br />Ant tt• van sa®n..n 1601 East Hazelton Avenue. P. 0. Box ®uln County <br />Gty of Escalon <br />fad tet Stockton. Cellfornla 95201' Gtyof Manteca <br />Fwn au®bee 209/46"781 city of Ripon <br />Daniel L. floe•• City Of Stockton <br />John D. most. M.D. City of Tracy <br />William J. Wad* Jogl Khanna. M.O.. M.P.H.. District Health Offtc•r San Joaquin County <br />Mary Anna low San Joaquin county <br />Address_ %�f- (� f.�1/ �%.l- 5�j�e, <br />Date of Inspection -a—J'01 Inspector <br />MONITORING ALTERNATIVE 05 <br />Annual precision test on tank(s) and piping. <br />Oaily-inventory reconciliation with submission of quarterly statement regarding <br />compliance with allowable variation. <br />Pipeline leak detectors on pressurized piping. l <br />Gaily operational check of suction piping function k_ <br />Calibrated meters for inputs and withdrawals: <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 test(s) must be performed by — — and results submitted to <br />this office within 30 days of the test. <br />02 -- <br />Pipeline leak detectors must be installed on pressurized piping by 7. <br />— <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 _moi — <br />6 Dispenser meter(s) must be calibrated by — __ _ 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 />