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v <br />w <br />0 <br />r� <br />H <br />hl <br />• ■ hfonitrtl'ear: O7- aL <br />' - Staffon Nerve: • . <br />Coaxial! 2 -Pout Phase I and Balance Phase 11 Vapor Recovery Systems Address: <br />This form was designed for use of dations vAth inspeclion toned up equipment defects at other issues requiring ftAher acifon. related to the noted repairs wftit (tie Log, Keep these records <br />Coaxial or 2 -Point Phase f with Ba ce Phase ll 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 f*ck Markin Record your fnitiats at the bottom of the farm after carnpletirg each day's by the Ak PotluSion Control Distrfct for a period of at least hvo years. <br />each box where your Inspection rataled no Inspection. Keep copies of work orders andlor equipment part receipts <br />problems, and an ".X" in each box where your <br />Day of the Month k oo ./ ✓ �,� <br />(Use TRAFFIC Gc?NES and SAFETY VF57S) 2 3 4 6 ti 7 $ 9 1 tI 11 12 -Y 3 IA 14 1 t; t7 11t la'n <br />VAKW A®CA <br />M <br />t. Vent fine PV vatve`s) present, yeR sticker, no vapor shadaws <br />2. Spill containers -clear? and dry <br />3. Spill container drains—operative afh1closed, chain attached (NappikableJ <br />v <br />� <br />4. Vapor caps -gaskets present &fig taps rat missing, broken or ksose <br />v% <br />") <br />5. Vapor adapters-figl?tan riser, dry k eakPoppet isTrot missfn damaged <br />r;. Fit caps -gaskets present 8110 tigh caosnotmissing broken orloose <br />i <br />r, Fill adapters attached tightly to r1sei inside gasket not missing or torn <br />a. Fill tube (coaxial spring4oadeto pre ent, round, sorrng not broken orsagging <br />✓ <br />/ <br />s. Coaxial gasket ln place, seat n9 v rs <br />• <br />10, Fill tube -(2-Point} present, round <br />i i. Air district decals-tegihle operating struabns correct complaint phone # <br />s2, Hoses -CA app! Wed, no kinksAt valsb1s, LRD Installed cotrectty <br />4T -----✓ <br />3. Breakaways,-r>RS-abaroved, w Jk Uid siainldtrstbtrlkWp <br />ta. Nozzles - CNW-appMved, has all cl ImAs, sAfmJs 1wrtr smooffily, no leaks <br />is, Nozzle hold-apenlatcihes •presents operatingeormay <br />ir, Nozzle bellows and fa-plalPs fight w nozzle, no tearslsfifs, wood seal <br />� <br />t r. Atozzie spouts -not /once; not out-nf- urrd, Have latch devices <br />ta. Nozzle Vapor Valves as vapor shado s emitting From rmzzle <br />Z.' <br />is. Hose Refractor -present with a 10" fess hose loop unless LRD present <br />