Laserfiche WebLink
Inspection <br /> Checklist <br /> Month/Year. { – --St a+11 <br /> station Mame: n�3 $ 'T'R@kC-1C 1 W0 <br /> Addiess- <br /> f�yr"i�i -L rifrs' 3 ern ; .sr, ma. a y nn i�L 3 ' `5 __. rte_ _ �, zrr -" <br /> nX,,,, ; .i ;: €" isa.e. 4 ;a>f� tJ�rsli•twG i 3iaS,3 �3 YGlI.11Jf ('\GLIJV F Jy"JLGtita �-ate::y'; fv}r. ALL!/ <br /> This form was designed for use at stations with inspection turned up equipment defects or other issues requiring further action, related to the noted repairs with the Long.Keep these records <br /> Coaxial or 2-Point Phase I with Balance Phase II Record descriptions of the noted defects and repairs on the Daily Repair Log. accessible in the Operations&Maintenance Manuel for inspection <br /> vapor recovery systems. Place aChack mark in Record your Initials at the bottom of the form after completing each day's by 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 and/or equipment part receipts <br /> .problems,and an"X"In each box where your <br /> �13 <br /> �#the M th <br /> {Ilse TRAFFIC Cfli+ls and SAFETY VESTS) Z 5 i6 1f 1 5 6 `i 3 1 Zfl 21Z 23 24 Z5 Z6 1 Z8 29 3D 3 <br /> TANK AREA 4 _ <br /> 1.Vent line PV valve(s)-present yellow sticker,no vapor shadows ,�' ✓ ti/.Y <br /> z. Spill containers-clean and dry W__ -_ _-_- ___— r ✓ �, ✓✓ ✓ ts" a,, I, <br /> 9•Spill container drains-operative and closed,chain attached(It applicable) �,/ �/�,,•✓ ✓ ✓' �/ ,..>y! <br /> 4.Vapor caps--gaskets present&tight,caps not missing,broken or loose yr 1 L✓ Poo, ✓ �,. ✓ <br /> 5,Vapor adapters-tight on riser,dry break poppet is not m1ss1hg1damageet ✓ vP ✓ ✓ ;r 1/ <br /> s. Fill caps-gaskets present and tight,caps not missing broken or loose ,. ,/ ✓ <br /> 7.Fill adapters-attachsd tightly to riser,inslde gasket not missing or torn ,/ ✓ L ✓,,,,;r.✓ <br /> a. Fill tube(coaxial spring-loaded)present,round in rnot broken or sa ✓ ✓n ` ✓ <br /> m sP 9 gy/ng <br /> 9,Coaxial gasket-in place,sealing vapors � _ _ — v y''°� ✓ ,� <br /> Mo.i'iA tuba-(2-Pobit)present,round _ ✓ �� ✓✓ <br /> DISPENSER AREA <br /> ii,Air district decals-leg/bM operating instructions,correct Complaint phone# -- v v v r/ v°✓ v L,�► <br /> 12. Hoses-CARB-approved,no kinksAuerslslits LRD installed correctly TT_ <br /> ✓ i,. ,� ,i �.. ,� v v ✓ <br /> ia, Breakaways-CARS-approved,no liquid stain/dust buildup y.✓ ,/ ;^ t✓ ,�%' J <br /> -14.Nozzles-CARB-approvers has all clamps,swivels work smoothly,no leaks f 4,r ✓ v *✓ J <br /> Is. Nozzle hotel-open latches present and operating correctly_ ✓ v <br /> is.Nozzle bellows and faceplates tight on nozzle,no tears/slits,good seal . ✓ ✓ ✓ <br /> 17. Nozzle spouts-not loose,not out-of-round,have latch devices Y t/ ,�`,r ✓ c/ <br /> is.Nozzle vapor valves-no�vapor shadows em/#/ng from noazle �' y,,. ,/ ✓ r�r , a i' } <br /> 9a. Hose Retractor-present with a 10".oriess hose loop unless LRD present ✓ �, � � y <br /> INSPECT AT LEAST ONCE PER WEEK <br /> 20.pram va or hose to remove excessive gasoline ) ,t� 4`: FrI <br /> INSPECTOWS INMAl,S: 77 <br /> r1Z. <br /> ;� L <br />