Laserfiche WebLink
'Month/Year - <br /> 1"nspection Check-list Station Name: t— <br /> Address; �3`i 5 1.)q C L r <br /> a <br /> Coaxial/2-Point Phase I and Balance Phase ll.Vapor Recovery Systems ac <br /> cam: This form was designed for use at stations with inspection turned up equipment defects orother issues requiring further action. related to the noted repairs with the Log. Keep these records <br /> Coaxial or 2-Point Phase J with Balance Phase 11 Record descriptions of the noted defects and repairs on the Dairy Repair Log. •''accessible in the Operations&Malntenartce Manual for Inspection <br /> vapor recovery systems. Pface aCtneckmark in Record your initials at-the bottom of the form after completing each day's by the Air Pollubon'Confrol 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 /> problerns,'and an'W'in each box Mere your <br /> ✓>/' ✓ '41 <br /> (use TRAFFIC CONES and SAFETY VESTS) 9 2 3 4 5 $ T S 9 141.1 12 13 14 15 f6 17 18 19 20 2? 22 M 241275 Z6 2T 28 29 30 34 <br /> _ — .. _. . .. . <br /> TANK AREA <br /> 1.Vent tine PV valve(s)-present yellow sticker,no vaporshadosn ✓ ✓✓ <br /> 2.Spilt containers-dean and dry ✓ ✓ ✓✓ ✓ ✓�/ ✓ <br /> s.Split container drains-operative and closed,chain attached(if applicable) ✓ ✓ ✓ ✓ ✓ <br /> a.Vapor caps-gaskets present&tight,caps net missing,broken or Those ✓ ✓ ✓ ✓ 7 17 ✓ ✓ •✓ <br /> 5.Vapor adapters-tight on riser,dry break poppet is not missingldamag+edf ✓✓ ✓ ✓+/ ✓ ✓ +✓• ✓✓ <br /> s.Fill caps-gaskets present and fight,caps not missing broken or loose ✓ ✓ ✓✓ <br /> Q <br /> w 7.Fill adapters attached tightly to riser,inside gasket not missing or lom ✓ ✓ ✓ ✓ ✓ <br /> a,FIN tube(coaxiaJ sprJng-loaded)present round,sprang nol broken•orsagyhrg ✓ ✓✓ ✓ <br /> s-Coaxial gasket 4h place,sealing vapors ✓✓ ✓ ✓✓ ✓ <br /> 10.FIN tube-(2-Point)present round ✓ ✓7[7 <br /> _DISPENSER AREA <br /> ti.Air district decals-legible operating instructions,correct complaint phone# ✓ ✓ ✓ <br /> 12.Hoses-CARS-approved,no kinksRears/siNs,LRD installed correctly , ✓/✓✓✓ ✓ <br /> 13.Breakaways-CARS-approved,no#quid staler/dust buildup .f ✓ ✓,/ ✓'�� <br /> 14.Nozzles:CARB-approved,has all clamps,swivels work smoothly,no leaks ✓7 7 Z ✓✓ ✓ <br /> 15.Nozzle hold-open latches present and operating correctly ✓✓ ✓✓ ✓ 1 77 <br /> bellows-and facephates4ghton Vitro <br /> twwwwur,good seat 64 rX U4 r- <br /> t7.Nozzle spouts-not loose,not oul-of-rourW,have latch devices 7 7✓✓ <br /> en 1e.Nozzle vapor valves-no vapor shadows emitting from nozzle 77777_777 ✓ ✓ 4/ ✓ <br /> 19.Nose Retractor-present with a 10"or less hose loop unless LRD present '✓ ✓w✓ tf <br /> co <br /> o INSPECT AT LEAST ONCE PER WEEK <br /> CD 20. Drain va orhose to remove excessive Rasolim N51 <br /> INSPECTOR'S HTIALS: <br /> 0 <br /> N <br /> W <br /> P <br />