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ManUvYaa <br /> Inspection Checklist Station <br /> tt,�r, � � /� <br /> Station Name: i'— <br /> Coaxial/2-Point Phase I and Balance Phase II Vapor Recovery Systems Foollity <br /> Address: <br /> This form was designed for use at stations with inspection turned up equipment defects or other issues requlring further action, related to the noted repairs with the Log. Keep these records <br /> Coaxial or 2-Point Phase I with Balance Phase II Record descriptions of the noted defects and repairs on the Daily Repair Log, accasslble in the Operations&Maintenance Manual for Inspection <br /> vapor recovery systems. Place aCheck mark in Record your initials at the bottom of the form atter completing each days by the Air Pollution Control District for a perlod of at least two years. <br /> each box where your inspection revealed no inspection, Keep copies of work orders andlor equipment part receipts <br /> problems,and an`X"in each box where your <br /> Da of the Month <br /> TANK AREA <br /> f Use TRAFFIC CONES and SAFELY VESTS) 1 2 3 4 5 6 7 6 9 10 11 12 13 1 a 4115116 M 1 B 19 20 21 22 23 24 25 26 27 28 29 30 31 <br /> _ <br /> 9. Vent line PV vafve(s)Preserd,yellow sdcka,no vapor shadows <br /> z Spilt containers-clean and dry /// / j / / <br /> 3. Spill container drains-operative and closed chain attached(It applJcable) <br /> 4, Vapor caps-gaskets present&t)gN caps not missing,broken orloose / 7 771771 / <br /> 6. Vapor adapters-tight on"ser,dry break poppet le not missingldamaged / / j <br /> 6. Fill caps-gaskets present and tight,caps not missing broken or loose / j / / / / / <br /> 7, FIl adapters-attached tightly to rise,Inside gasket not missing or tom <br /> 8 /Cl�ucyk5� u� 71/. i <br /> If- (6:(k GVr�t �6'.—r✓� Gy� / j j, / / / / / 717z— <br /> DISPENSER <br /> / / <br /> ✓, <br /> to. Ghees K • ,�•�cct �`."�w�. c�t�'c_C- vs �c / / // /-j � <br /> DISPENSER AREA , <br /> 11.Air district decals-legible operating Instructions,correct complaint phone# j/ j <br /> 12.Hoses-CARB-approved,no k/nks/tears/sUts,LRD Installed corrscgy / / <br /> /-V/ <br /> 13. Breakaways-CARE-approved,no liquid staln/dust buildup / <br /> ia.Nozzles-CARS-approved,has all clamps,swNa/s work smoothly,no leaks // j %"x <br /> 16.Nozzle hold-open latches-present and operating correctly � �/ �7 j / �:- j <br /> 16.NozzJe bellows and faceplates 419ht on nozzle,no teatslslds,good seal <br /> tr.Nozzle spouts-not loose,not out-of-round have latch devices / / j / j <br /> la.NozzJe vapor valves-no vapor shadows emitting from nozzle / j j / �,✓ j j" 1",-1/J/1" <br /> 1g_Hose Retractor-present with a 10'or less hose loop unlessLRD present <br /> INSPECT AT LEAST ONCE PER WEEK <br /> "eo.Drain va r hose to remove exc��I : <br /> oline - / <br /> 1 1 <br /> INSPECLS: <br />