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, <br /> --v n..n3H-dH(999)OS9{o61UG0 !eluoo pl nOLls slagel <br /> ._..,InnY Bulmollol 01 U <br /> SECTION 5: Equipment Checklist for Healy/VST Sites <br /> M Inspection must be performed dally.If no problem exists,place a"✓^in the appropriate <br /> &repairs on the"Equipment Repair Log".Keep copies of repair orders or receipts In the Ora ge Binder.Proper perso alplace protective equipment(PPE)m st be used at all defects <br /> times.Refer to the Process Card In the pocket of the Orange Binder for assistance in performing this daily checklist. <br /> Month l%O1 r j— Year_ <br /> 1DAY OF THE MONTH <br /> ,,,t; "1. .2' 3 .4' S .6.' 7 .8. 9 70 <br /> eck 11 12 13 1d, 15 16 17 B. <br /> . 1. Chhoses for leaks,kinks ny7,or tears entl that swivel moves <br /> flat spots,crack s w 7 79 '2B $t 'y2 23 24 25 QB 27 28 29 $A 31 <br /> maeN <br /> 2. Check that breakaways are installed correctly(arrow,should point toward noels) ✓ v ` ~ r <br /> and that mere are m visibN leaks. v :. — '� ✓.� •L% ✓ �. ✓ <br /> 3. B hose rams of co are present,check maf hose reh ✓' L ✓'• ✓ ✓ r .'� ..i .✓ , <br /> ma13 inches o/cord showk�g. xbre Nnction ell have was •� ..r ✓.V ✓ ✓'✓ �� ✓ f ✓ .v d <br /> 4.(VSTIOALANCE ONLY)Check That gasoline hoaes do rot touch the ground. <br /> 5.(VST/BALANCE ONLY)Drain liquid from hoses into an appropriate container <br /> entl check mal amount is less than a/ew ounces atter 2 attempts. <br /> 6 Check <br /> n � <br /> sales(ar Hops,leaks.or otlors_ <br /> 7. Check that faceplate/facetn goad c,mdition.kook for tears,sltts 8 ` ✓ '� v Y " 1'" <br /> deterioration.Plastic seal on Noecone surrounding spout is not cracked or broken V s.- `� v t' ✓ "'` <br /> 8. Chock mini booWapor collection slaew for Were wsles. <br /> 9. Check that Insertion lnlsdock mechanism Nnceonsroe <br /> 10.Check mat auto shutoNthold open I P P -� '� b ;` ✓ t' y ! 'd, ✓'d <br /> M etch ts Present entl functional, �' r' �' s V '� � V '✓ ✓ � ✓ ' <br /> 11.Check mat male check valve N functioning, v .�.. "�- ✓ '✓ V '! :' ✓ ✓ .V, ✓ ✓ .V <br /> Property clamped wahmvapw � ✓ `� V .y. .4 ✓ �' .✓. ✓ ✓ <br /> 12. Check that me mats-pout's war.round and chobstruction. <br /> char of y e '� y ✓ .✓ ✓ ✓ ✓ ✓ '✓ if ,/ <br /> ✓ .Y �. ..•• .Y• .� V. ✓ <br /> 13. Check that the latch ding(rane0 morel ring on spout)ie present ✓' y ✓ � V . '"' '� f ! ✓ ' <br /> 4.Check that the/showing decUs xm prawn)nn serh Jhpnnu Ne//N ✓ ✓ ✓ °� ✓ ✓ ✓ <br /> Instructions,Gaselne Warning,Gclsl14 Ton free NuadNr for NI pl a born III <br /> applicable) v .v. <br /> 15. Check Ihel a 111 bushels ere aNen An r <br /> 18 Are drainvolWsfunplbne wr Y a aaaa <br /> 17. Ara gaskets In Mond w Nt rte N N <br /> 18' Check that fill wNot a a A 1' <br /> 1S. CMck m-Iq erd oda <br /> tt r <br /> .r~ <br /> 20. UNIT Monitoring-JI M <br /> v '✓. _ 400011y <br /> r <br /> 21. CompNls the Nwrdaua ' ' to V1 ✓ <br /> Hazardous Wash Chsollkals NIo 1 u sd Ilona <br /> 22. CampNb Me Nealy �Y gel pin end Twtlnp ChaehlNt /_ � �w • <br /> (YoNlM atldnbnslHu w ' t! w ., •.•. <br /> N IMh I7MMbklep �;� ,•�, <br /> 23. Confirm and record That AD - w�' J:.�. , <br /> Mls N <br /> Iwk roheMvbsan au of tonm <br /> tl l0 10 gelbns per minuN. <br /> 4. <br /> 24. <br /> mtherem are no vapor shsdowaecheck for pts w pin yea I IINI eawAvhee sticker is vtsibm a <br /> r , <br /> 25. Db you compNts ms INIeatlt rougbppl LaNI7 <br />