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Inspection Month/Year: ����7 <br /> Checklist - <br /> Station Name: <br /> Address: <br /> Coaxial/2-Point Phase I and Balance Phase 11 Vapor Recovery Systems Facility PTO <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 II Record descriptions of the noted defects and repairs on the Daily Repair Log. accessible in the Operations&Maintenance Manual for inspection <br /> vapor recovery systems. Place aCheck mark in Record your initials at the bottom of the form after completing each day's by the Air Pollution 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 /> Day of the Month <br /> (Use TRAFFIC CONES and SAFETY VESTS) 112 3 14 15 16 7 18 19 110111112113114115116117118119120121122123124125126127128129 30 31 <br /> TANK AREA <br /> 1.Vent line PV valve(s)-present,yellow sticker,no vapor shadows <br /> z.Spill containers-clean and dry <br /> 3.Spill container drains-operative and closed,chain attached(if applicable) <br /> a.Vapor caps-gaskets present&tight,caps not missing,broken or loose V <br /> 5.Vapor adapters-tight on riser,dry break poppet is not missing/damaged X XX <br /> r <br /> 6. Fill caps-gaskets present and tight,caps not missing broken or loose <br /> 7. Fill adapters attached tightly to riser,inside gasket not missing or tom <br /> E. <br /> 9A,--- <br /> Aapors <br /> 1o. Fill tube-(2-Point)present,round <br /> DISPENSER AREA <br /> 11.Air district decals-legible operating instructions,correct complaint phone# k` <br /> 12. Hoses-CARB-approved,no kinks/tearslslits,LRD installed correctly ' { <br /> 13. Breakaways-GARB-approved,no liquid stain/dust buildup <br /> 14. Nozzles-CARB-approved,has all clamps,swivels work smoothly,no leaks r ' <br /> 15.Nozzle hold-open latches-present and operating correctly <br /> 16.Nozzle bellows and faceplates tight on nozzle,no tears/slits,good seal <br /> 17. Nozzle spouts-not loose,not out-of-round,have latch devices <br /> 18.Nozzle vapor valves-no vapor shadows emitting from nozzle <br /> 19. - t <br /> INSPECT AT LEAST ONCE PER WEEK <br /> 120. <br /> INSPECTOR'S INITIALS: <br />