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Pm 70._1 (ear ---0 �t <br /> Inspection Checklist Stet nNrame - -- <br /> Address: <br /> Coaxial/2-Point Phase I and.Balance Phase'll Vapor Recovery Systems a° ' <br /> This form was deslgn-od for use at slaunns with inspection turned up equipment detects or other issues requiring further action relalpd to the noted repairs volh the t rxd Keep these..•riots <br /> Coaxial or'2-Paint Phase I with Balance Phase. If Recon2desceptions of the noted defects and repaus on the Umily Repair Lou amelsible In the Operations A Mainlonanee Manna'tui insprclion <br /> vapor recovery systems. Place aCheck nl:uk u1 Record your initials at the bottom of the form after completing each day's by the Air Pollution Control( istof I for ;r penod Of or Icnsl two years <br /> each lox where your inspection revealed no inspection. Keep copies of work orders andlor equipment pad receipts ' <br /> problems.and an"x"in each box wherd you <br /> _ _R <br /> _Da of the Month <br /> (Use TRAFFIC CONES ind SAFETY VESTS) C_I__J3 4 5�_7 7T8 9 10 11 12 13 14 15 16 17 18 19J20I21I22I23L�25126I27[28L29FQI3I <br /> TANK AREA J / <br /> I Vent line PV valve(s)present, yellow sr r kw oo vapor shadows f -_ _ - �/� - f -- — -y V V' <br /> __ � / ✓ J_ 1 <br /> 2 Spill containers-clean and dry ✓ V ✓ ✓ ✓ l V V ✓ V <br /> T Spill ccntaaler drains -operative and closed Oban)artached(if applicable) ✓ _ ✓ _- t/ V ✓ <br /> x Vapor caps-gaskets present R fight cups nut nussinq. broken or loose VV VVVV/ ✓' �• y <br /> 5 Vapor adapters-fight on nsey dry break puppet is nu!rnia'srng/rhlrnayr(d � V ✓ V, V/ V _ -� -V I/_ V j 44t V V V7 V, <br /> 6 Fill caps goskels present and light r ap not miss nq hroken or loucu ✓ t f V <br /> Fill adepteis attached tightly to nsev. rr side yaskn!not rnrssniy or Iorn tv V � IVIV/ <br /> II I tope(1 I I pang to Idrd) p r t L spr iy Ir bmlgv ,yymd ,. V Jq t odxiai gdskf t i place a Illno v IFe ti � VVIo I Il tube (7 Pomt)pnc e ni remit - _ _- <br /> DISPENSERAREA <br /> I I Au district decals-legrble operating rnsburfrons cony r I complaint Phone h <br /> Ir Horns-CARB approved no krnksRears/shl I HD halloo`Lrv,o1 fly � / ✓ /' / , / <br /> V /V V v /I <br /> I I fir .Ikaw rys CAHB-approved no hgmff sl I Nrhai buildup y • /- k/ <br /> .._ /. V <br /> la Nuzzles (AHff eppruved has all Ckuup swwels work snnolhly no leaks V <br /> 15 Nozzle hold open latches present and opr sting couecfly VV. ✓ �/ If V <br /> Ia Nozzle bellows and laceplales light On no de,, no feaNslrts. Iloud s<:ul V <br /> V Nozzle spools not louse nal Out(if ound,have latch de.v'r es k/ - V/ y - - <br /> Is. Nozzle vapor-calves ao vapor shadows emitting front nozzle - - - -� _ - --- - - " '✓ ___ <br /> 1a Hose Retractor present wnh;r f0"or less hose loop unless 1 RO present ✓ <br /> INSPECT AT LEAST ONCE PER WEEK_ <br /> 20 Dram vae2r hose to remove ext sslve gasoline <br /> INSPECTOR'S INITIALS' <br />