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0 <br />a <br />s <br />12- <br />MonthlYear: p — ©f— <br />Inspection Checklist StationNarne:` Tr .26 �f <br />Address: Z3 7S 7AFC1/ !31-V0 <br />Coaxial/ 2 -Poiret Phase I and Balance Phase 11 Vapor Recovery Systems Facility PTO V. <br />This form was designed for use at stations with inspection turned up equipment defects or other issues requiring further action. related to the noted repairs with the Log. Keep these records <br />Coaxial or 2 -Fount Phase i vhth Balance Phase 11 Record descriptions of the noted defects and.repairs on live Daily Repair Log. accessible in the Operalons & Maintenance Manual for inspection <br />vapor recovery systems. Place aCheck mark in Record your initials at the bottom of the form atter completing each day's by the Air Pollution Control District for a period of at least brio years. <br />rk <br />each box Where your inspection revealed no inspection. Keep copies of woorders and/or egUIPMenI part receipts <br />problems, and an "X" in each box where your <br />/✓,�ti/✓✓. "'' X I -J ✓, �ioa� orAttr�r�r l�'/1 <br />(Use TRAFFIC CONES and SAFETY VESTS) <br />TANK AREA <br />t. Vent line PV valves) -present, ye/low sticker, no vapor shadows <br />✓ <br />✓ <br />✓ <br />"� - <br />r"'� <br />z. Spill containers -clean and dry ✓ <br />✓ •✓' ve v' <br />✓ <br />✓ ✓ <br />✓ tr <br />✓ ✓' <br />s. Spill container drains -operative and closed, chain atlached (/f applicable) ✓ <br />✓ -Z ✓ <br />Y <br />>/ a ✓ <br />ta. Breakaways -CARES-approved, no liquid stain/dust buildup t% ti/ �✓' <br />"✓ ✓ *✓ c/ <br />✓ ✓ ✓ ✓ ✓ <br />4. Vapor caps -gaskets present & tight, caps not raising, broken or kaase <br />✓ ✓ <br />✓ <br />G/ '✓ <br />14. Nozzles - CARS -approved, has all clamps, swivels work smoothly, no keaks ✓ <br />✓ <br />I/ ✓ �/ / ✓ <br />5. Vapor adapter; -tight on riser, drybreak poppel is nol missirrgldamaged <br />1/ <br />~,/' >✓' <br />✓ <br />is. Nozzle hold -open latches -present and operafing corredly ✓ V`� <br />`� <br />F, Fill caps -gaske/s present and tight, caps not missing broken orkwse <br />V✓ <br />✓ v <br />✓ <br />✓ ✓ <br />7. Fill adapters attachf d tightly fa riser, inside gasket not missing or tom <br />✓ ✓ �/ `f <br />✓ ' V <br />✓ <br />✓ ✓ <br />a- Fill tutre (coaxial sprang -loaded) -present, round, spring not broken orsaggft <br />�/ <br />✓ ✓ t/' <br />t/ <br />L/. <br />s. Coaxial gasket -in place, seat/ng vapors ✓ <br />f ✓ <br />�% <br />�i <br />'✓ <br />✓ ✓ <br />i <br />tri. Fill tube -(Taint) present, round <br />✓ <br />✓ <br />✓ <br />t9. Hose Retractor -present with a f0"oriess hose loop unless LRtJ present <br />✓ �' <br />4 <br />DISPENSER AREA <br />ii. Air distdcl decals - legMle operalina instructions, correct complaint phone ti t/ <br />✓ <br />✓ <br />✓ ✓ <br />12. Hoses - CARS -approved, no kinksReam/siils. LRD installed correcby <br />✓ ✓' <br />ta. Breakaways -CARES-approved, no liquid stain/dust buildup t% ti/ �✓' <br />"✓ ✓ *✓ c/ <br />✓ ✓ ✓ ✓ ✓ <br />14. Nozzles - CARS -approved, has all clamps, swivels work smoothly, no keaks ✓ <br />✓ <br />I/ ✓ �/ / ✓ <br />is. Nozzle hold -open latches -present and operafing corredly ✓ V`� <br />✓ <br />✓ -✓ ✓ t/ <br />'Ia. Nozzle bellows and faceplates iighl on nozzle, no tears/slits, good sea! <br />✓ V' <br />Y <br />— ✓ <br />IT. Nn?zle spouts -not krnse, not out -of -round, have Ja(ch devices <br />✓ ✓ t/' <br />✓ <br />✓ V <br />Nozzle vapor valves aro vapor shadows emitting from nozzle <br />✓ ✓ <br />t9. Hose Retractor -present with a f0"oriess hose loop unless LRtJ present <br />✓ �' <br />l <br />INSPECT AT LEAST ONCE PER WEEK <br />20. Drain vapor hale to remove excessiveyasolir <br />�_� nLSPECTOWS INITIALS: <br />