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BOARD OF TRUSTEES SAN J" JUIN LOCAL HEALTH OISTRIC SEAVIwo <br /> Jame@ Culbertson, Pros. I%.- %woa City of Lodi <br /> Patrlcl■ E. Vannuccl, Secy. 1601 East Hazelton Avenue, P. 0. Sox 2009 San Joaquln County <br /> Anthonette Van Spronaen City of Escalon <br /> Earl Plmentel Stockton, Callfornla 95201 Cltyof Manteca <br /> Fern Bugbee 209/4$8-6781 City of Ripon <br /> oanlel L. Flores <br /> . City of Stockton <br /> John D:Mast, M.D. City of Tracy <br /> William J. Wade Jopl Khanna, M.D., M.P.H., District Health Officer San Joaquin County <br /> Mary Anna Love San Joaquin County i <br /> Facility Name I /^a trt Z_ I � <br /> AddressS , (� (��-G� /ems -4v � <br /> Date of Inspection Inspector MGt/� <br /> MONITORING ALTERNATIVE 15 <br /> 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 /> Weights and Measures sticker <br /> V---Certification by qualified repairman <br /> Implementation of thisimonitoring alternative requires that the following CIRCLED items <br /> be completed by the specified dates. <br /> Precision test(s) must be performed by —,3_4547 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 <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 vari t , s that <br /> exceeded allowable.* The first statement is due by rj <br /> 6. Dispenser meter(s) must be calibrated by , - — with copy of <br /> certification or Weights and Measures sticker number submltt d 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 />