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A <br /> Inspection <br /> Checklist <br /> MonthlYear.Station Name:Address; 7CL atU <br /> CoaxiaU 2-Point Phase I and Balance Phase 11.Vapor Recovery Systems -F;icff'ry <br /> This form was designed for use at stations with inspection fumed up equipment defects or other Issues requiring further actior-L related to the noted repairs vrtth the Log. Keep these records <br /> Coaxial or 2-Point Phase I vrith Balance Phase It 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 aC heck rnark In Record your Initials at the bottom of the firm 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 tonere your <br /> Da xof the Month <br /> tUse TRAFFIC CONES and SAFETY VESTS) 1 2 1 3 4 5 6 7 8' 3 110 11 12 13 14 1$16 17 18 19 20 2'f 22 23 24 25 26 27 28 29 3U 31 <br /> TANK AREA <br /> 1.Vent line PV valve(s)-present,yellow sticker,no vapor shadows <br /> 2.Spill containers-clean and dry <br /> 3.SpilI container drains-operative and closed,chain attached(if app)fcable) <br /> 4.Vapor caps-gaskets present&fighl,caps not missing,broken or inose tA <br /> ® s.Vapor adapters-fight on riser,dry break poppet is not missingfdamaged <br /> x s.Fill caps-gaskeli present and tight caps not missing broken or loose <br /> w 7.F91 adapters attached tightly to»ser,inside gasket not missing or tom <br /> a.Fill tube(coa)ial spring-loaded)-present,round,spring not broken or sagging <br /> �9.Coaxial gasket-in plaoe,sealing vapors <br /> io.Fill tube=(2-PoJn*present round <br /> DISPENSER AREA <br /> ti.Air district decals-legible operaling instructions,cermet complaint phone# <br /> 12.Noses-GARB-approved,no kinksRearslsdts,LRD installed corred/y <br /> 13.Breakaways-GARB-approved,no kgvkf slain1dusf buifdtlp <br /> u.Nozzles-CARS-approved,has alt damps,stvivels work smoothly,no leaks t <br /> is.Nozzle hold-open latches-present and operating correcdy <br /> 1a-Noa�Jeketle�vsapolaseplates FigJer�ae�t, <br /> 17.Nozzle spouts-not loose,not out-of-mind,have larch devices All <br /> ?a.Nozzle vapor valves aro vapor shadows emitting from nozzle <br /> is.Mose Retractor present wr2h a f 0"oriess hose)aop unless LRDpresent <br /> INSPECT AT LEAST ONCE PER WEEK <br /> 0 2o. Drain vapor hose to remove excessive gasoline <br /> \ INSPECTOR'S 1NTrMS: <br /> m <br /> x <br />