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cep --o % 12--- <br />--'Inspection Checklist <br />Coaxial/ 2 -Point Phase I and Balance Phase 1( Vapor Recovery Systems <br />Monlh1Year: <br />Station Nafr,e' <br />Address: V3 iS 7X#c B,L,6/P <br />act m! <br />This form was designed for use at stations wfth inspedion turned up equipment defects or other issues requiring further action. related to the noted repairs with the Log. Keep these retards <br />Coaxial or 2 -Point Phase f with Balance Phase it Record descriptions of the noted defects and repairs on the Daily Repair Log, accessible in the Operations & Maintenance Manual for inspection <br />vapor recovery systems. Place aChack mark in Record your initials at the bottom of the fomr after completing each day's 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 anddor equipment part recuts a <br />problems, and an "X" in each box where your � <br />�'✓tel ✓"../ti/ � i n�,� „r tt,e an.....h <br />(Use TRAFFIC CONES and SAFETY VESTS) <br />E <br />no <br />ative and closed, chain attached (it appikab) <br />nt,& tight, caps not misslog, broken orloose <br />W. dry breekpoppef is not misskVdamagex <br />and tight coos not missing broken orloose <br />yto riser, inside gasket not missing or tom <br />Jed) -present, round, spring not broken or sa <br />11. Air district decals - legible operafftV fnStrudaons, correct complaint phone 9 <br />sz. Hoses - CARE? -approved no kinksReerafsiits, LRD installed correcby <br />va. Breakaways-CARSapproved rro tiquidstafn1dustbuifdup <br />K Nozzles - CARS -approved, has all clamps, swivels work smooftdy, no leaks <br />is. Nozzle hold-upen latches -prasent and operating cormcfly <br />16. Nozzle bellows and faceplates ,fight on nozzle, no fearstslr7s, good seat <br />17. Nozzle spouts not loose, not out -of round, have latch devices <br />ts. Nozzle vapor valves -no valoor shadows emftiing from rxrzzle, <br />7. Vent line PV valve(s) -r <br />2. Spill contairwrs -cfean a <br />a. Spill container drains •01 <br />s. Vapor caps -gaskets pre <br />s. Vapor adapters -tight on <br />>.= <br />s Fill caps -gaskets these <br />7. Fill adapters -attached tis <br />s. FW tube (coaxial spdng4 <br />s. Coaxial gasket -ln place, <br />to. Fill tube - (2 -Pant} prese <br />E <br />no <br />ative and closed, chain attached (it appikab) <br />nt,& tight, caps not misslog, broken orloose <br />W. dry breekpoppef is not misskVdamagex <br />and tight coos not missing broken orloose <br />yto riser, inside gasket not missing or tom <br />Jed) -present, round, spring not broken or sa <br />11. Air district decals - legible operafftV fnStrudaons, correct complaint phone 9 <br />sz. Hoses - CARE? -approved no kinksReerafsiits, LRD installed correcby <br />va. Breakaways-CARSapproved rro tiquidstafn1dustbuifdup <br />K Nozzles - CARS -approved, has all clamps, swivels work smooftdy, no leaks <br />is. Nozzle hold-upen latches -prasent and operating cormcfly <br />16. Nozzle bellows and faceplates ,fight on nozzle, no fearstslr7s, good seat <br />17. Nozzle spouts not loose, not out -of round, have latch devices <br />ts. Nozzle vapor valves -no valoor shadows emftiing from rxrzzle, <br />