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oct.11ti a: equipment unecklist for Healy/VST Sites <br /> An Inspection must be performed daily.If no problem exists,place a"✓'In the appropriate box. If a defect is identified,place an "X"in the a <br /> ppropriatbox- <br /> defects&repairs on the"Equipment Repair Log". Keep copies of repair orders or receipts in the Orange Binder.Proper personal protective equipment(PPE)Record <br /> must be used <br /> at all times. Refer to the Process Card in the pocket of the Orange Binder for assistance in performing this daily checklist. <br /> Month_0 Year_ f1_ DAY OlsTHEMONTH <br /> 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 20 29 tI 31 <br /> I Check hoses for leaks,kinks,flat spots.crackingor tears and that swivel moves - <br /> ✓ L, 4. V V V <br /> 2 Check that breakaways are installed correctly farrow should point toward nozzle) <br /> and that there are no visible leaks. <br /> ✓ V ✓ ✓ v <br /> 3. h hose retractors are present,check that hose retractors function and have ✓ <br /> less that 3 orches of cord showing. <br /> 4 (VST�BALANCE ONLY)Chock that gasoline hoses do riot touch the ground. <br /> 5. (VST/BALANCE ONLY)Drain liquid from hoses into an appropriate container <br /> and check that amount is less than a few ounces alter 2 attempts. <br /> Nozzles <br /> 6. Check nozzles for drips,leaks,or otlors. " <br /> ✓ ` <br /> ].Check That/aceplatelfacecone is in gootl contlilon Look for leans slits 8 � � " ✓ t" � � \- � � .� <br /> deterioration Plastic seal on facecone surrounding spout is not cracked er broken. ✓ ✓ <br /> 8. Check mini boot vapor collection sleeve for tears or sills. v L' k..• •-+ ✓ L ✓ y c' Y • \,. e <br /> r ✓ v <br /> 9.Check Thal insertion Interlock mechanism lunctrons properly � e _ `' v v ✓ • „ •.. ,. W <br /> u ✓ ✓ ` <br /> 10. Check that auto shutoWhold open latch is present and functional. _ ✓ _ ✓ - � <br /> "� ✓, r r y J ✓ ` ✓ <br /> 11. Check that nozzle check valve is functioning,properly clamped with no vapor � � '- v \� ✓ ` <br /> 12.Check that the nozzle s - �' ✓ ✓ ✓ \' N' v u �- ✓ a. <br /> pout is tight,rountl antl clear of Obstruction. ` ✓ v y 6 <br /> ✓ v <br /> 13. Check that the latch ring(raised metal ring on spout)is present ✓ `� • \. v \. <br /> Dispensers �. v ✓ t. <br /> ✓ <br /> 4 <br /> 16.Check That the following decals are present on each dispenser Nozzle <br /> Instructions,Gasoline Warning,Octane.Toll Free Number for Nozzle Problems(if <br /> applicable). ✓ ,,,,. ✓ IJ <br /> Tank Area .. `- . ✓ '� ✓ �. .,. ✓ ✓ �.. W <br /> 4: <br /> 6. Check that split buckets are clean antl dry _ ✓ v£ <br /> i6.Are drain valves functional and pull chains aba0ed? 4 <br /> t].Are gaskets in fill and vapor caps In good condkian? r `� + `� ` r t. y <br /> 18. Check Ihal till 8 vapor adapters lock in place and cannot be turned with hand. .; — � v � v <br /> 19.Check that vapor drybreak seal Is 11ght antl spring is working. ✓ — ✓ ✓ �z � '^ ✓ ✓ t. ., <br /> ✓ <br /> MonMorin Area - t' ". _ �' � :+ •. •. <br /> 20. UST Monitorin ' •' >,. `; a""w • _ <br /> g System s powered on and not in alarm \ � ✓ ✓ ,✓ � 'v v ' <br /> FGfi. ' <br /> t. Complete the Hazardous Waste Weekly Checklist(go to the additional <br /> Hazardous Waste Checklists provided in this booklet) �, <br /> 22.Complete the Healy , <br /> NST Equipment Weekly Inspection and Testing Checklist l 11 ICI' I • r + J <br /> (go to the capital Healy Weekly Checklists provided In this booklet) <br /> MOn Ins cNon <br /> 23.Confirm and record that nozzle flow rate is between 6 to 10 gallons per minute. <br /> 24. Visually crack for i valve on vent riser 8 that yellow/white sticker is visible 8 ' <br /> there are no vapor shacows <br /> 25. Did you complete the Monthly Throughput Lou <br /> Inspectors Initials <br /> Time of Inspection,if required <br /> I F- <br /> r L <br /> C <br />