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a Monttr/Year: <br /> Inspection Checklist Station Name: <br /> Coaxial/2-Point Phase I and Balance Phase II Vapor Recovery Systems Aaaress: z ` , <br /> a� <br /> This form was designed for use at stations with Inspection turned up equipment defects or other Issues requiring further action, related to the noted repairs with the Log. Keep these records <br /> Coaxial or 2-Point Phase I with Balance Phase it Record descriptions of the noted defects and repairs on the Daily Repair Log. accessible in the Operations&Maintenance Manual for)nspectlon <br /> vapor recovery systems. Place aCheck mark In Record your inftlals at the bottom of the form after completing each day's by the Alr Poliudcn Control District for a period of at least two years, <br /> each box where your inspection revealed no inspection. Keep copies of work orders and/or equipment part receipts <br /> problems,and an"X"in each box where your <br /> Dav of the Month <br /> TANK AREA <br /> (Use TRAFFIC CONES and SAFETY VESTS) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18�19 23 24 25 20 21 22 26 27 28 29 30 31 <br /> t.Vent line PV valve(s)Present,yellow sticker,no vapor shadows �' / <br /> 2 Spill containers-clean and dry <br /> ;, Spill container drains-operative and closed,chaln attached(if applicable) <br /> 4.Vapor caps-gaskets present&tJghl caps not missing,broken or loose /; / / "111/1 <br /> r7. <br /> or adapters-tight on riser,dry break poppet/s not mlsslngldamaged � % / <br /> caps-gaskets present and tight,Laps not frdssing brok6n orloose <br /> dapters sftachad tightly to rise,Inside gasket not mlWng or tomit <br /> �lie�k +V\, -t— 1VeS <br /> DISPENSER AREA <br /> 1,1,Air district decals-legible operating Instructions,correct complaint phone <br /> 12.Hoses-GARB-approved,no kinksRears/siits,LRD installed correctly <br /> L1413. Breakaways-GARB-approved,no liquid stalnldust buildup.Nozzles-CARB-approved,has all clamps,swivels work smoothly,no leaks <br /> 15_Nozzle hold open latches-present and operating correctly <br /> 16. NozzJe bellows and faceplates-tight on nouJe,no teara/sRs,good seal <br /> 17.Nozzle spouts-not loose,not out-of--round have latch devices / AA/ <br /> i s.Nozzle vapor valves-no vapor shadows etniHfng from nozzle <br /> ig_Hose Retractor-present with a 10"or less hose loop unless LRD present L I <br /> INSPECT AT LEAST ONCE PER WEEK <br /> 2o.Drain va r hose to remove axceszlve aaol)no / <br /> INSPECTOR'S INMALeo - ` <br />