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Inspection ' �IicnihlYear: '�
<br /> 'Checklist. . . S#anon Na ne: =�2}+�Q7/wyS�IT�f /�Q aZ
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<br /> Tr,'ss form was designed for use at stations with rspec<ion turned-ip equipment defects or other issues requiring further action. related to the noted repairs rrith the Log. Keep these records
<br /> Coaxial or 2-Poi-rt Phase i with Balance Phase If Record descriptio:-of the noted defects and repairs on the 0aify Repair Log. accessible in the Operations&Maintenance Manuel for inspection
<br /> vapor recovery systems. Place aCheck mark in Record your Mit9ais at the bottom of the fora after completing each day's Say the Air Pollution Control District for a period of at least two years.
<br /> each box where your inspection revealed no inspection. Keep copies of work orders andlor equipment;part receipts
<br /> problems,and an'X*in each box where your
<br /> Day of the Month
<br /> (Use TRAFFIC CONESandSAFET?•VESTS) � [ �1��� �4�� ��(�� �� ��� � �� �i����2j��1�����
<br /> TANK ARE-A
<br /> i.Vent line PL!i alve(s)present,yelf2w slicker,no vaporshadows ✓;°' t./ ✓t±� V" ✓l t �/./ ./r ✓ �/ +/'
<br /> z.Spill containers-clean and dry ✓ �' .® ti/ oo°t✓���,/✓, �� �— �/ v
<br /> ss.Spill contained drains-pneratnve and closed,chain attached(it applicable) Noo, ✓ ✓ �•
<br /> { a.Vapor caps-ctaskets present&light,caps not missing,broken or loose; � v � ''� ✓�Y � �s or✓ V f�✓_ ✓ o./✓ ✓ i✓
<br /> 5.Vapor adapters-I aht on riser,dry break poppet is not missing1darnagedr v ✓ '✓ ✓ /+s i `�'✓ ✓ v. �✓ ✓ �/ V ✓ ✓ ✓ ✓ ✓
<br /> a Fill caps ga$kA-ts plesent and tight caps not missing broken or loose ✓ ✓ We A-,l✓ i�-" i cit'M �.,. ✓r ,� ;�/l,� e�t✓ �/ i
<br /> i T. Fill adapters;3tzached tightly to riser,inside gasket not missing ce torn °� ✓ j ! V'I✓ 'es'a/E✓j✓�✓ v �/� I�/ ✓PV
<br /> 1!j✓ o i
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<br /> a. Fill tube(coaziat spring-loaded)present,round,spring not broken or sagging *s" �'' '` ✓ia/ ✓(✓Y i✓ R/- ,i .�°,/�t" ✓;✓ J �/ ✓ ✓
<br /> { s. Coaxial gasket-in place,leafing vapors e0'4/*i/✓ ai r/ 3+' t/ 4,/ t f o f ,✓I l✓ c/h/ f/ A
<br /> j,o. Pill'tube-(21abint)pr sent:round ✓ !/Ly _✓ ✓ 1 t ✓ ;� ai 1 / ✓ ✓ q/` ✓
<br /> DISPENSER AA
<br /> 1..-Air
<br /> district de'rats-legible operating instnictions,co.recr complain;p;one t"'�tf '✓ 'O` ✓ `✓ �i°�i t,r✓ ✓ ✓TZ 7i ✓ ✓1 i
<br /> 1.2 Noses-CARS-approved,no kiniWears/slits,1.RD insealed co�elA iL'"°V °J 'f ✓ ✓ ✓` v J ✓✓ V° t �/ ,
<br /> l i 1 j ! 1 l ✓4 1 1 ✓ 1 �/ Imo. 1
<br /> 13Breakaways,CARB-approved,no 11quid stair-Adust buildup 1r✓, ✓ ✓'✓t ✓ ✓ ✓ ai .l1 ✓ Y✓ ✓ ✓i`r 1 j
<br /> 14.Nozzles-CAR-5-approved,has 8/1 c/amps,swivels work smoothly..no ledge ;✓ '� ✓ "� ✓ ✓ 1� �" a✓�✓ ✓i✓° i V'✓ ✓j
<br /> 15 Nozzle:hold-open latches-present and operating correctly V^ ✓ ✓ i/'`�('-! ✓v io &I".PI.✓ ✓tv t l.J vj
<br /> ho. Nozzle bellow's and faceplates dight on nozzle,no tearslslits,good seal '"�✓.�€✓$✓, ✓ t/ v ✓,t/1/ Y � ✓ t
<br /> 17. Nozzle'spoubs;-not loose,not cwt--of-round:have latch devices V %I/ L011v L,e/ �,/{/ �/ ,/ L, ,
<br /> is. Nozzle;vapor.waives 4.o vaporshadows emitting mom nozzle V/` '✓ d ✓ ✓ toe r/ ✓,/ ✓ i
<br /> 99. Hose Retractbt-present with a!011 ar less hose loop unless tn`rJ present ✓ ✓ t/ ✓ ! I v 1✓t ✓
<br /> INSPECT AT LEAST ONCE PER WEEK -
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<br /> Drain vapor hose to remove excess'rre gasoline FT
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