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Maintenance/Repair Log and Site Name: N40'T o-,Q / <br /> Address: I 54— <br /> ISD Alarm Log CKY: <br /> p C- C>faq-* - <br /> ISD Alarm Date/Tlme <br /> Date/Tlme Date/Time Technician Information <br /> as Indicated Date of Component Service Performed and the Service <br /> Problem Service Call 4 Name,Affiliation,Phone Number and <br /> Discovered' on Console Made3 Certification Numbers Removed Outcome <br /> (If applicable) from Service° <br /> 7D V,3 <br /> �� �lld Sk.✓t ''` �7 j j} � N �v� p�2•t-e L <br /> Llai X111 �rrCd Z. �i� Vj TUC NA-e-A <br /> NJL(c 4ze-t- <br /> 'Record date and time any vapor recov_ery�eguipment problem (damaged or defective eg4ment_or__ISD alarms)wasAiscovered: <br /> 2Record the name of the ISD alarm as it reads on the ISD console. <br /> 3Record date and time the service call was made. <br /> 4Record date and time service was performed. <br /> 6Record certified repair technician's name,company affiliation, phone number and certification number from applicable manufacturer. <br /> 6Record date and time component was taken out of service, if applicable. <br /> 7Record brief explanation of service performed, Including outcome of service (repaired,tested and returned to service,waiting for parts,etc). Any and all actions <br /> taken to identify the cause of an ISD alarm, Including the actual results of tests performed In accordance with the IOM requirements for that alarm(rssults <br /> may be attached),must also be noted here or In supporting documents. <br /> 57/ <br /> '—Rev.8/20i1 2 <br /> . i ; <br />