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SECTION 5: Equipment Checklist for Healy/VST Sites 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 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 at all times. Refer to the Process Card in the pocket of the Orange Binder for assistance in performing this daily OAV OF THklist. Month r Year � � 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 H MONTH 19 20 21 22 23 24 25 26 27 28 29 30 31 Hoses check hoses for leaks.kinks.list spots,cracking,at fears and that swivel moves ✓ f. I freely. _ z. 2.Check that breakaways are installed correctly farrow shoultl paint toward nozzle) and that there are no visible leaks. ' ✓ ✓ +� L a. 3 1 hose retractors are present,check that hose retractors function and have ' ✓ ✓` C V V 1. less that 3 inches of cord showing. STIBALANCE 0 Check that gasoline hoses do not touch the ground. STIBALANCE ONLY)Drain liquid from hoses into an appropriate container I t and check that amount is less than a few ounces after 2 attempts. Nozzles :. . . ✓ `` v 6.Check nozzles for tlnpaleaks ar odors. ` V 7 Check that faceplate7acecons is in good condition.Look for tears.slits& v ✓ v ✓ ` 1, ✓ (_. c ✓ ✓ V V V deterioration.Plastic seal on faceeone surrounding spout Is not cracked or broken. ✓ ✓ ` ✓ y e., v �" ✓ ` - ✓ V v v t W ✓ e. Check mini bootroapor collaclion sleeve for tears or slits. ✓ ✓ � t, V 9.Check that insertion interlock mechanism lundions properly. �✓ V ` ` �,, ✓ ✓ ✓, ,. ✓ ✓ ✓ ✓ 10. Check Ilial auto shutoff/hold open latch is present and functional. c. ✓ o� L r. u t/ V V r- ✓ '� °" " ✓ 4 ( 4 ✓ 11 Check that nozzlecheck valve is functioning,property clamped with no vapor V V �, V ✓ r- r. ✓ 11/ ti 4 ✓ 12.Check that the nozzle spout is tight,.round and clear of obstruction. ✓ � � C 1. v V k � t/ � 13 Check that the latera ring ire rad metal ring on spouq is present. 14.Check that the lollowing decals are present on each dispenser.Nozzle v V V ✓ V L.- 1/ a- y ✓ Instructions.Gasoline Waning.Octane.TO Free Number for Nozzle Problems(If V V L ✓ r. v L applicable). v "' `- a.. ✓ . an Area 1. t/ v ✓ J < 4 ✓ V ✓ V � 15.Check that s Ill buckets are clean and dry. v ✓ 4. a.. r r,v v ✓ ✓ v Are drain valves functional and pull chains atfachetl9 ✓ L- J <' ✓ ✓ v 4 u l Are gaskets in till and vapor caps kt good condition? v v v ✓ ✓ �' �• ✓ ✓ 18.Check that fill 6 vapor adapters lack in place antl cannot be turned with hand c, L. v v ✓ ✓ V k' v � 19.check that vapor drybreak seal is fight and spring is working - Montfort Area v v ✓ , 20.UST Monitoring System s powered on and not in alarm ✓ ✓ ✓ ffre sof ry 121 Co Ins y oto the atldlfonal "-`f ' �O /� f rT t 3 2t.Com tete the Hazardous Waste Weekly Checklist(g •/• �. r . dote Was ehVSTsts provided in this booklet) 22Com 1 p ely Equipment Weekly Inspection and Testing Checklist too to the additional Healy Weekly Checklists provided In this eookou so '111,84111111Ot onthly IttlipeCt.ti 23. Confirm and record that nozzle flow rate o between 6 to 10 gallons per minute. / 24visually check far PN valve on vent riser&that yellow/white sticker Is visible there are no vapor shadows. 25. cid you complete the Monthly Throughput Log? '�'�_I Inspector's Initials: Time of Inspection,if required