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r <br />-inspection <br />Coaxial! 2 -Point Phase I and Balance -Phase 11 Vapor Recovery Systems Facility <br />This form was designed lar use at siatlons with Inspection turned up equipment defects or other issues requiring further action. related to the noted repairs eAith the Log. Keep these records <br />Coaxial or 2 -Point Phase 1 with Balance Phase II Record descriptions of the noted defects and repairs on the Daily Repair Log. accessible in the Operations & MaWenance Manual for inspection <br />vapor recovery systems. PJace aC heck mark in Record yore initials at the bottom of the form after completing each days 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 a ndlor equipment part receipts <br />problems, and an "X" in each box where your <br />'�>/,/,%✓✓ ✓✓ Dav of the Month <br />MordWYear: <br />10 <br />Station blame; <br />— 6 <br />Address: <br />4. Vapor caps -gaskets present $ fight caps not missing broken or loose VV ✓ <br />� <br />(Use TRAFFIC CONES and SAFETY VESTS) <br />rwuv worn <br />t. Vend lire PV valve(s) -present, yellow sticker, no vapor shadows1/1 <br />2. Spill containers -cleen and dry V, V Al <br />s. Spill container drains -operative and closed, chain attached tit applicable) <br />4. Vapor caps -gaskets present $ fight caps not missing broken or loose VV ✓ <br />s. Vapor adapters -tight on riser, dry break poppet is not miss-ftVdamaged '� .% <br />s. Fill caps - gaskets present and tight, caps not missing broken or loose ✓ <br />7. Fill adapters -attached tightly to riser, inside gasket not musing or tam ✓ ✓ ✓ <br />a. FIR tube (coaxial spring-loaded) '-present, round, sptrng not broken or sagging c/ ✓ <br />a. Coaxial gasket in place, seating vapors ✓ ✓ <br />to. Fill tube -(2-Point) present round V- V.- <br />Vl3Yt-Nr_KAKCA <br />gr, Air dlstrictdecals -Legible operating instructions, correct comptalnt phare # <br />72. Hones - CARB-approved no kinksRears/drits LRD installed correctly <br />.ja. Breakamys -CARS-approved, no fiqukl sfain/dust buildup <br />14. Nozzles -GARB-approved, has all clamps, sivlveis tyorx smoothly, no Leaks <br />15. Nozzle hold -open latches mpresent and operating cwmctiy <br />ia. Nozzle bellows and faceplates -light on nozzle, no tears/sUTs, good seal <br />17. nozzle spouts -not loose, not out -of -round, have latch devices <br />1e. Nozzle vapor valves4io vapor shadows emr?fkV from nozzle <br />ig. Hose Retractor -present with a 10" or less hose loop unless LRD present <br />INSPECT AT LEAST ONCE PER <br />ova excessive asoline 7 - I I I I`>> <br />INSPECTOR'S IMMLS: '°'I •' ' ` <br />.i <br />