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uP <br /> 4� GR Job# 7 7200007 <br /> X040 Emergency Shut-Off (ESO) Testing Results & Checklist <br /> Facility Information Contractor Information <br /> Site# Arco SS 2186Co. Name: TEST Results <br /> 925-55 <br /> Phone 1-7555 <br /> Address: 3212 N.California z5-55-Ryan Inc. Date: 1/5/2017 <br /> C /St: Stockton, CA Lead Technician: Tim Adams <br /> eMaint.W.O.# 10071978Name: x PASS <br /> Passport: or <br /> Si nature FAIL(Next Day Repair Required) <br /> The objective of this test Is to provide assurance that the when the E-Stop switch is activated,all the fueling system circuits(turbines,and dispensers)are de-energized,and <br /> remain de-energized until they are re-set manually). The test procedures and guidelines shall be in accordance with the E-Stop Testing Process. <br /> # The follow/ng Information/s to be completed. <br /> X To select <br /> SITE DATA Y„ No wa <br /> 1 Number of E-Stop switches: 1 <br /> 2 Type of Switch? Push Pull x Momentary Plain light/Toggle Other <br /> (if Momentary type, locate and identify re-set button): In Elect Room — <br /> 3 Type of Turbine Control Relay System(Electrical Distribution Center): <br /> _Brown Box _Power Solution x Other <br /> 4 Type of Turbine Control Rela s: Make Fe Petro —Custom Fabricated <br /> 5 T Model MAG YFC ,h <br /> e of Line Leak Detection: Mechanical m n/CPT <br /> PERFORMANCE TEST x PLLD <br /> 6 Does the E-Stop shutdown power to the DISPENSERS <br /> 7 Does the E-Stop shutdown power to the TURBINES _ x <br /> 8 Is the 220 voltage to the turbine relay removed(either the line side or the motor side of the contacts or the coil)? <br /> g Are the DISPENSER BREAKERS clearly identified/labeled? x <br /> 10 Are the TURBINE BREAKERS clearly identified/labeled? x j <br /> 11 <br /> Are all the ESOs accessible and clearly identified/labeled? x <br /> 12 Did the ESO(s)function correctly(de-energized from eitherthe line side or the motor side of the contacts or the coil)? x <br /> 12A If#12 is NO, briefly describe what was wrong: <br /> 12B How was it corrected: <br /> 12C If repair or ESO functionality cannot be corrected same day(prior to leaving the site). The technician MUST notify the Site <br /> Manager of the problem, place an"Out of Service"Tag on the ESO(s),and identify an alternate mean(i.e., locate circuit <br /> panel,clearly identify turbine and dispenser breakers for shut-off in the event of an emergency). <br /> 120 Elite Customer Solution Center has been contacted for the repair. <br /> eMaint.W.O. Ticket# <br /> POST TEST <br /> 11 Site's fueling system is fully operational. <br /> 12 All equipment secured and any access ports, lids,enclosures are closed. x <br /> 13 All safety barricades, and any debris was been removed. x <br /> x <br /> COMMENTS <br /> -,,• ter, <br /> ENTAL HEALTH <br /> r— TM-E �1 <br /> ibmit completed copy with other documentation In E-Maintenance. <br />