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�llt� Mapec con Chiaclk�o ° Balance EVR Phase 9 KYear, <br /> h :(incleilding 9IN VC 3m10C syste s) and ame: <br /> Two Point Phase I Vapor Recovery Address , <br /> Inspection frequency: Five (5) days per week, unless throughput is less than 25, 000 gallons per month then weekly Inspections are required. <br /> instructions: Place a check mark (✓) in each box if no problem is found. Mark with an "X" any box If a problem Is found. Record any problems in your repair lord . Keep the; <br /> records In your Operations and Maintenance manual for five (5) years. See the reverse side of this form for more Information. <br /> Day of the Month <br /> 1 2 4 5 6 7 11 9 10 11 12 13 14 115 16 17 lia 19 20 21 22 23 12412!=211 <br /> Tanlcs area Phase I Vapor Recover <br /> 1Papor <br /> PV valve--Present No debris. Check for shadows. / I f / l i > ! / <br /> Spillntainer— Clean and dr i <br /> ontainer drain valve- C/osed not dama ed.ter— Ti ht on riser, swivels ro erl . / 1l ter ca Ti ht, asket resent, noe—Present, DPW ack screw assembl ti ht <br /> adapter— fight on riser, poppet present, <br /> alic <br /> inedlnot damaged, swivels properly. <br /> t3. Va or ca Ti ht, asket resent. l l / l � � <br /> Dls enser Area Phase II vapor Recover <br /> 9 , Air District decal—Present w/correct toll-free number l l77 <br /> 7/ 7 <br /> 1 o . Hose- EVR-certified, no kinks/slits/tears, LRD <br /> Installed correct/ l / / l 1 / <br /> 11 . Nozzle—EVR-certified, has all clamps, no leaks, <br /> s out not loose (inspect VST nozzle daily, if applicable / V <br /> 12. Latch rim --Present, in good repair l l l / <br /> 13 . Bellows and faceplate—Present, in good repair <br /> 14. Hold open latch—Present, in good repair (except for <br /> VST nozzle without Secondaty Release Mechanism) <br /> 15, insertion interlock mechanism--operates properIv / / / l ` / - — <br /> 16. Breakaway:—Present, EVR-certified, no leaks l l / / ` � <br /> 17. Drain va or hoses of excess asoline <br /> . 18. Refractor—O erates ro erl , in ood re air - <br /> Quarterly Inspection : /f installed, Check Healy Clean Air Separator tank for proper ball valve position . Date Inspected : <br /> Ball valve A : open/closed Ball valve B : open/closed Ball valve C : open/closed Bal ! valve D : open/closed <br /> �raM �c�®� 's Aaaeea9� : <br /> Rev. Aug <br />