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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. It a defect is identified,place an"X"in the appropriate box. Record <br /> defects 8 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 daily checklist. <br /> ) i DAY OF THE MONTH <br /> Month !IA n e Year 0 _ 1 1 2 1 3 1 4 T-5-1 6 1 7 1 8 1 9 1 10T11 I 121131141151161-17T-i8-1 19 120121122123124125126127128129130131 <br /> Check hoses for leaks.kinks.flat spots.cracking,or tears and final swivel moves ✓ ✓.. ,� �. ✓ ✓ <br /> L <br /> t'Ireely. ✓ <br /> 2.Check that breakaways are installed correctly(arrow should point toward nozzle) ✓ i v a-,.. L/ ✓ ✓„ ✓ ./ <br /> and that there are no visible leaks. t./ <br /> 3 a hose retractors are present,check that hose retractors function and have ✓ <br /> less that 3 inches of cord showing. <br /> 4. (VST/BALANCE ONLY)Check met gasoline hoses do not 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 after 2 attemptsEf. <br /> Neatiflear <br /> 6.Check nozzles for dips.leaks or odors. <br /> 7.Check that tateplalellacecone is in good condition.Look for tears,slits 8 V <br /> deterioration Plastic seal on tacecone surcounding spout is not cracked or broken. `� ✓ ..- �' V 4 V �- `� .✓ - �+' ✓ V 4 v <br /> _ ✓ ✓ ✓ r <br /> S.Check mini boouyap it collection sleeve for tears or slits. ✓ ✓ �-- `� 4 v u-' " v - <br /> 9.Check that insertion Interlock mechanism functions properly. ✓ "` " a_ " r' ^r ✓ ✓ V ✓ <br /> 10.Check that auto shutoff/hold open latch is present and functional. ✓ ✓ ..- V �` ✓ v V <br /> 11.Check that nozzle check valve is functioning,properly clamped with no vapor Iv ✓ v V �- `� ✓ v . '� <br /> ✓ v <br /> 12,Check that the nozzle spout is tight,round and clear of obstruction. v `� f.' ✓ .. ✓ <br /> 13.Check that Ne latch ding(raised metal ring on spout)is present. ✓ ✓ ✓ v �"- ~ `� ✓ e.' <br /> Dispensers <br /> 14.Check that the following decals are present on each dispenser'.Nozzle <br /> Instructions,Gasoline Warning.Octane,Toll Free Number for Nozzle Problems(II ' ✓ V V v,. ` . ✓ <br /> r v. <br /> Tank A. L- <br /> e <br /> 15.Check that spill buckets are clean and dry, y ✓ u. 6. ` u ~ V - ' ✓ <br /> 16.Are drain valves functional and pull chains attached? k- `-' °'` " "' ✓ ✓ ✓ ✓ ✓ ✓ r` V <br /> 17.Are gaskets in fill and vapor caps in good COndition? ✓ ✓ vIS <br /> ,� v ✓ ✓ �.. v ✓ �- 4 `"" `" c ``. 4 <br /> v 4d ✓ w ✓ <br /> 18. Check that(1118 vapor atlapters lock in place and cannot be turned with hand. ✓ v v �' L' <br /> 19. Check that vapor drybreak seal is tight and spring Is working, v r v ✓ t+ s- V o- ` rr <br /> Monitoring Area . ..,.. - . <br /> 20. UST Monitoring System is powered on and not in alarm. �- i "� ✓ '� V V - '' ✓ <br /> Weekly Inspection: Record the date of in <br /> 21.Complete the Hazardous Waste Weekly Checklist(go 10 the additional <br /> Haaardous Waste Checklists provided in this booklet) h <br /> 22.Complete the HealylVST Equipment Weekly Inspection and Testing Checklist n <br /> f^ <br /> (go to the additional Healy Weekly Checklists provided in this booklet) / r �� ,✓ i l✓ r f <br /> M oh Record the deft orrfrepapoillitan `,•1'" - ', <br /> 23.Confirm and record that nozzle flow rate is between 6 to 10 gallons per minute. e ' <br /> 24. Visually check lot PN valve on vent user 8 that yelbw/while slicker is visible 8 <br /> there are no vapor shadows. ✓ ) 1 <br /> 25.Did you complete the Monthly Throughput Log? <br /> Inspectors Initials: <br /> Time of Inspectionit required <br />