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- <br /> Inspection <br /> Checklist <br /> MonlhiYear: _ r <br /> Station Name: 4_E <br /> Address: 3`t 'PRC f-1)' t <br /> Coaxial/2-Point Phase I and BalanceAase 11.Vapor Recovery Systems ac' • <br /> n: This form vets designed for use at stations with Inspection turned up equipment defects or other issues requiring further action. related to the noted repairs W ih the Log. Keep these reoords <br /> Coaxial or 2-Point Phase I vMh Balance Phase It Record descriptions of the noted defects and repairs on the Daily Repair Log. ''accessible In the Operations&Maintenance Manual far inspection <br /> vapor recovery systems. Place aChack mark in Record your Initials at the bottom of the form after completing each day's a by the Air PoDution Control District for a period of at least two years. <br /> each box where your Inspection revealed no inspection. Koep'copies o€vtork orders andlor equipment part receipts <br /> problems,'and an' 'in each box%-Mere your <br /> (Use TRAFFIC CONES and SAFETY VESTS) 1 23 4 $ 6 7 8 9 10 1.1 12 13 14 15 16 17 l8 19 2Q 2t 22 23 24 25 2fi 27 28 29 30 31 . <br /> TANK AREA <br /> t,Vent tine PV valve(s)-present yellow sticker,no vapor shadows ✓ ✓ ✓ ✓ V,V +,/" '✓ ✓ <br /> z.Spill containers-clean and dry ✓ n✓'✓✓ ✓ ✓ <br /> 3,Spill contalner drains-operative and closed,chain attached(ff q*tcabie) ✓ ✓ ✓ ✓ V ✓ ✓ ✓ ✓ ✓ <br /> a,Vapor caps-gaskets present&tight,caps not missing,broken orioose ✓ ✓ ✓ ✓ ✓ ✓ ✓✓ <br /> z <br /> s,Vapor adapters-(fght on riser,dry break poppet is not missing/damaged ✓✓ ✓ ✓ ✓ ✓ ,I ✓ ✓ ✓ <br /> s. Fill caps-gasketi present and fight,caps not missing bmken or loose ✓ <br /> w r.Fill adapters attached tightly to riser,inside gasket not missing or tom ✓ ✓ ✓ ✓ ✓ ✓ ✓ <br /> a.FSIf tube(coaxial spring-loaded)-present,round,spring not broken-or sagging ✓ /✓ ✓ 'f ✓ ✓� <br /> s.Coaxial gasket-ln piace,searing vapors /✓ ✓✓ ✓✓ Z,/ ,/ ✓ ✓ <br /> 1 o.Fill tube-(2-Polho present,round 17 <br /> ✓ ✓ ✓ �✓ V, ✓+/' ✓ ./ ✓ ✓ <br /> .DISPENSER AREA <br /> 11,Air district decals-legible operating MstntcUoas,correct complaint phone it V ✓ ✓ ✓✓ J •f <br /> 12.Hoses-CARS-approved,no kinksdearmWITs,LRD Installed comctfy ✓ ✓ f✓✓ ✓ ✓ J ✓.t/✓✓ ✓✓ <br /> ta.13reakavrays-CARSapproved,no liquid stain/dust bufidup ✓ ✓ ,l ✓ ✓ ✓ <br /> 14.Nozzles-CAR&gpproved,has all clamps,ssvfvek work smoothly,no leaks %,/7-777 ✓✓ ✓ ✓ ✓ ✓ ✓ 1 <br /> 15.Nozzle hold-open latches present and operating correctly ✓ rl✓ ✓ ✓✓ ✓ ✓ i./ ✓ <br /> esti , <br /> M Nozzle spouts-nd loose,not out-of-round,have latch devices ✓✓ ✓ 7 7 ✓✓ ✓ ✓ `✓ <br /> d ✓ ✓ / ✓ R/ ✓✓ ✓ � ✓- f <br /> � ta.Nozzle vapor valves-no vapor shadows emitting from nozzle <br /> 1g.Hose Retractor-present with a f0"or less hose foop unless LRD present ✓tf {f ✓ ✓ ✓ ✓ <br /> co <br /> o INSPECT AT LEAST ONCE PER WEEK <br /> 2o. Drain vapor hose to remove excessive 2asoline <br /> c` MPECTOWS IMM S: ° �} `r ,S 11 <br /> 0 <br /> cv <br /> 0 <br /> z <br /> P <br />