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Inspection
<br />MonWea r. — -- /
<br />Station Name: _
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<br />Coaxial/2-Point Phase I and Balance Phase Il- Vapor Recovery Systems
<br />Address: LV
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<br />This form was designed for use at stations vir9t inspection turned up equipment defects or other issues requiring further action.
<br />Coaxial of 2-Point Phase 1 with Balance Phase If Record descr9pllons of the noted defects and repairs on the Daily Repair Log.
<br />related to the noted repairs with the Log. Keep these records
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<br />vapor recovery systems. Puce aCheck mark in Record yow Initials at•the bottom of the form after compleling each day's
<br />each box Mere your inspection revealed no Inspection. 'copies
<br />-'accessible,
<br />by the Air
<br />in the Operatlons & Maintenance Manual for inspection
<br />Pollution Control District for a period of at least two
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<br />Keep of work orders andlor equipment part receipts
<br />problems, and an "X" in each box where your
<br />years.
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<br />(Use TRAFFIC CONES and SAFETY VESTS)1 2 3 4 5 6 7 8 9 1a 11 12 13 14 15 16 17 1 18 2a 27 22 23 24 25 26 27 2 29 as 31
<br />TANK AREA
<br />1. Vern line PV valve(s)-preserd, yeNow sticker, no vaporshadovvs v' ✓ ✓ f
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<br />2. Spill confair►ers -clean and dry ,i •,ir f f
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<br />s, Spill containerdrafns -operative andclosect chaln attached (r "ficable) ✓ t/ ,/ f ✓ f
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<br />a. Vapor caps . gaskets present a fight caps not missing, broken or loose ✓ r/ /' •/ o,d ✓
<br />S. Vapor adapters -f M on riser, dry break poppet is not missing/damaged V1�/ ✓ J �/ f f N/
<br />✓
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<br />s. Fill caps -gaskets present and bgM, ceps rrof missing broken or loose ✓ ✓ ✓ ✓ �' ✓ f
<br />✓ l�
<br />r. Fig adapters -attached fthtlyto riser, inside gasket not missing or tom ✓ L/ `l I! r /
<br />✓ V-
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<br />s. Fill tube (coaxial spring-loaded)present, round, spring not broken arsagging '� ✓ e/ ✓
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<br />s• Coaxial gasket 4n place, seaLrrg Vapors✓ ✓ _/
<br />✓ /
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<br />1o. FBI lube - (2-Point) present round ,/ V ,� �/ ,� , f
<br />DISPENSER AREA Q '
<br />11. Alf district decals -legible operating fnsfruations, carred complaint phone # JV �' ✓ 1/` ,/
<br />, f �./
<br />12 Hoses - CARS-epproved, no ldnksvfeaaWslits� LRD installed correctly *� ✓ ✓ ,/ e / E f , f ve
<br />✓ ✓
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<br />13. Breakaways -CARE-approved, no 1lQuld staWdust buildup >' *✓ f v"
<br />14, Nozzles -GARB-approved: has allctamps, swivels warltsmoothly, no leaks V ✓ +/ ✓ ✓
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<br />fs. Nozzle hold-open latches -present and opera tingcnrractly :/ ✓ y • / `/ ✓ ✓•ZXv
<br />✓ %/
<br />16. Nozzle beltol4s and faceplates light on nozzle, no feamWils, good seal J' ✓ A/ �% �% — ,,/ ✓
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<br />17. Nome spouts -not loose, not out-of round, have latch devl ees A
<br />1s. Nozzle vapor valves -no vapor shadows eMft g from nozzle `' ✓ ./ /, �� ,/
<br />..% 771/11/
<br />1a Hose Retractor -present x*h a Worless hose kap unless LRD present v" 1 ,✓ tJ �%
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<br />INSPECT AT LEAST ONCE PER WEEK
<br />20, Drain vapor hose to remove excessive gasofne r
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<br />INSPECTOR'S AMM, °J .lJ 67 * ,
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