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SECTION 5: Equipment Checklist 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 appropriate box. Record <br /> defects&repairs on the"Equipment Repair Log".Keep copies of repair orders or receipts in the Orange Binder. Proper personal protective equipment(PPE)must be used <br /> at all times. Refer to the Process Card in the pocket of the Orange Binder for assistance in performing this dally checklist. <br /> Month , ,L Year--- <br /> 1 /} DAY OF THE M 11 O 11 NT11 H <br /> Hosea lt1 2 3 4 5 6 7 8 9 10 71 72 13 14 15 16 17 78 19 20 21 22 23 24 25 26 27 28 29 30 31 <br /> a <br /> 1 Check hoses for leaks,kinks,Ila)s ols,cracking or leers antl that swivel moves <br /> freely <br /> 2. Check Ihaf breakaways are installed correctly lanow should point toward nozzle) t. ✓ ✓ t- ✓ <br /> antl that(here are no visible leaks. �.. V V V, � ✓ <br /> 3. If hose retractors are present,check that hose retractors function and have ✓ - (/ r <br /> less that 3 inches of cord showing. ✓, ✓ J v <br /> 4 (VSTiSALANCE ONLY Check that gasoline hoses do not touch the ground. ✓ V '� `-•' <br /> ✓ ✓ ✓ <br /> 5.(VST/BALANCE ONLY)Drain liquid from hoses into an appropriate container <br /> and check that amount Is less than a few ounces after; aaempls. <br /> ozzift <br /> 6.Check nozzles for drips leaks.or otlors. - <br /> ✓ ✓ .• <br /> 7. Oheek that faceplatelfacecOne is in good contlilion.Look for tears,slits 8 �� ✓ v v L, <br /> y <br /> deterioration.Plastic seal on facecone surrounding spout is nal cracked or broken. ✓ y <br /> 8.Check mini boobvapor collection sleeve lar fears ar slits. ✓ ` v ✓ V r' <br /> �.. ` v v v t✓ ✓ `✓ �. V L v <br /> 9. Check that Insertion interlock mechanism functions properly. ✓ ✓ � k' `� '� V r- _ �, v V ✓ <br /> 10. Check that auto shulo3/hold open..,on is present and functional. z ✓ '� ✓ V V y ✓ y <br /> V v ✓ .� _ .. ✓ ✓ ✓ ✓ ✓ o <br /> �1. Check that nozzle check valve i5 functioning,properly clamped with no vapor _ _ t' •� ✓ � �� ✓ .,,. v ✓ ✓ <br /> ✓ ✓ ✓ V ✓ <br /> 12 Check that the nozzle Spout is tight,rountl and clear of obstruction. '� � V '- � J <br /> 13.Check that the latch ring(raised metal ring on spout)h present ~ V •' '✓ ✓ ✓ ✓ ✓ <br /> of naters: <br /> V ✓ ✓ <br /> 14. Check That the following tlecals are present on each dispenser Nozzle <br /> Instructions,Gasoline Warning.Octane,Toll Free Number lar Nozzle Problems d7 <br /> applicable). J J <br /> V 4 <br /> Tank Area ... .. � � _, ✓ <br /> ' i. ✓ ♦ /V ✓ <br /> 15.Check that spill buckets are clean and dry. - <br /> 16.Are drain valves functional antl pull chains allached't <br /> t 7.Are gaskets in fill and vapor caps in good condition? d ✓ ✓ �' ✓ ✓ ✓ <br /> v ✓ ✓ ✓ ✓ <br /> 18. Check that fill 8 vapor adapters lock in place and <br /> 19.Check that vapor drybreak seal is tight and spring, working. ✓ ` `� t' <br /> nrl Alta t, s_ v. c ✓ v �, <br /> ✓ V r t <br /> UST Monitoring System is powered cn and not in alarm. - <br /> ee tion• - ti �.. ,,- ;,._ � <br /> 21. Complete the Hazardous Waste Weekly Checklist(go to the atlditwnal _ <br /> Hazardous Waste Checklists provided in this booklet) <br /> 22. Complete the HealYNST Equipment Weekly Inspection and Testing Checklist 6 <br /> (go to the additional Healy Weekly Checklists provided in this booklet) <br /> Months n <br /> 23 Confirm and record that nozzle flow rete is between 6 to 10 gallons per minute. * �" <br /> 24. Visualy,check for PN valve on vent riser&Ihaf yellow;white sticker is visible& <br /> there are no vapor shadows. <br /> 25.Did you complete the Monthly Throughput Log? / <br /> � I <br /> Inspector's Insists <br /> Time of Inspection,it requiretl <br />