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t _ -inspection Checklist <br />Coaxial/ 2 -Point Phase J and Balance Phase ii Vapor Recovery Systems <br />This form was designed fol use at stations with inspection fumed up equipment defects or other issues requiring further action. ' related to the noted repairs W1h the Log. Keep these records <br />Coaxial or 2 -Point Phase I with Balance Phase II Record descriptions of the rioted defects and repairs on the Daily Repair Log, accessible in the Operations & Maintenance Manual for inspection <br />vapor recovery systems. Place aCheck mark in Record your initials at the bottom of the form after completing each days by the Air Pollution Control District foT 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 where your <br />'�✓ ,f ✓r/,�✓ ✓ e month <br />(Use TRAFFIC CONES and SAFETY VESTS) 1 2173141 5 6 7 8 9 1 t} 11 12 13 14 3i5 16 17 18 19 20 21 22 23 24 25 26 271281291301: <br />MontiiNear: <br />J <br />Station Name., <br />L/ <br />✓ ✓ ✓ <br />Address: <br />7 <br />%� C� L-(/ <br />acr <br />�G <br />g <br />1. Vent line PV valves) -present, yefiow sfkker, no vapor shadows <br />J <br />2, Spill containers -clean and dry <br />L/ <br />✓ ✓ ✓ <br />3. Spill container drains -operative and clazK chain attached (fapplicable) <br />✓� v' <br />t/ `% ✓ <br />4. Vapor caps -gaskets present A fiyhf, caps not missing, broken orloose <br />�./ <br />"� ✓ <br />s. Vapor adapters -tight on riser, dry break poppet is not missin f/darnaged <br />'� ✓ <br />✓ <br />6.1`11 caps -gaskets present and fight, caps not missing broken or loose <br />✓ <br />c/ <br />7. Fill adapters aftacibed tightly to riser, inside gasket not missing or tam <br />✓ ✓ <br />✓ <br />e, Fill tube (coaxial spring-loaded) -present, round, spring not hroken or sagging <br />✓ <br />✓ <br />s. Coaxial gasket -in place, sealing vapors <br />✓ ✓ <br />to. Fill lube -(2-Paint) present, round <br />✓ <br />DISPENSER AREA - <br />1 t. Air district decals -legible ooerar7ng instrtrdions, correct complaint phone 9 <br />12. Hoses - CARS-goproved, no kinkshears/sU7s, LRD installed cormcffy <br />13. Bmakeways-CARSapproved, no liquid stain/dust bulldup <br />14. Nozzles - CARS -approved, has all clamps, sru'veA work smoothly, no leaks <br />— ts-Noale-hol�petriatches�rreseni'arrd`opsraiing-Corredlq <br />1s. Nozzle bellows and faceplates .8ghton nozzle, no fearsrsb7s, good seal <br />27. Nozzle spoLds-rmtfoase, notout-of-round, have latch devices <br />ta. Nozzle vapor valves -no vapor shadows emitting from nozzle <br />se. Hose Retractor-presenfivAh a 10'orless hose loop unless LRD present <br />