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OARO OF TRUSTEES <br />s Culbertson. Pres. <br />P. trials E. Vannuccl. Secy. <br />110*n0te Van Spronsen <br />E%d Pimentel <br />Fera Sugbee <br />Daniel L. Flores <br />John 0. Mast. M.D. <br />William J. Wade <br />Mary Anna Love <br />Facility Name <br />SAN J04PIN LOCAL HEALTH DISTRIC <br />1601 East Hazelton Avenue, P. O. Box 2009 <br />Stockton, California 85201 <br />209/466+7eq J6 g 34/�( 9 <br />Joel Khanna. M.O.. M.P.N.. District Health Officer <br />Address Q� d S �1.eAdW7 /tee. <br />Date of Inspection Inspector Z14/1', <br />2 e, ,-- .2-- <br />SERVING <br />City of Lodi <br />San Joaquin County <br />City of Escalon <br />i City of Manteca <br />City of Ripon <br />City of Stockton <br />City of Tracy <br />San Joaquin County <br />San Joaquin County <br />MONITORING ALTERNATIVE #5 <br />Annual precision test on tank(sj and <br />_/Daily inventory reconciliation with submission ofuarterl state <br />compliance with allowable variation. q y statement regarding <br />Ao!n <br />Pipeline leak detectors on pressurized piping. <br />Daily operational check of suction piping function. FAL vG �P <br /><k -Calibrated meters ftir'inputs and withdrawals:%�� t <br />Weights and Measures sticker�E <br />u �FS <br />Certification b'���' <br />y qualified repairman y <br />Implementation of this monitoring alternative requires that the following CIRCLED items <br />be completed by the specified dates. <br />Precision test(s) must be performed byf�,J D4e <br />this office within 30 days of the test. and results submitted to <br />6. <br />Pipeline leak detectors must be installed on pressurized piping by 6 —3O 'b <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 />Submit quarterly statement to this office that allowable variation on inventory <br />reconciliation has not been exceeded or a list of dates a d varia inns that <br />exceeded allowable.* The first statement is due by _ <br />14Dispenser meter(s) must be calibrated by _ _ a�"� — <br />certification or Weights and Measures sticke n msubmitted to with copy of <br />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 />IW4 <br />