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by GR Job# 98202642 <br /> Emergency Shut- (ESO) Testing Results & Checklist <br /> Facility Information Contractor Information TEST Results <br /> Site#Arco 2093 Co. Name: Gettler-Ryan Inc, Date:B/3 0/20 1S <br /> Address: Phone 925-551-7555 <br /> 3425 Tracv Blvd Lead Technician:David Rouse x PASS <br /> City ,t St:Tra c CA Nam .. or <br /> eMaint.W.O.# 101L3 0 Passport: FAIL(Next Day Repair Required) <br /> Si nature <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 following Information/s to be completed x Te select <br /> Yes Ko rt1A <br /> SITE DATA <br /> 1 Number of E-Stop switches: 2 <br /> 2 Type of Switch? Push Pull X MomentaryLl Plain light/Toggle Ocher: <br /> (if Momentary type,locate and identify reset button): In Elect Roam <br /> 3 Type of Turbine Control Relay System(Electrical Distribution Center): <br /> El Brown Box X Power Solution J__I.Other Custom Fabricated <br /> 4 <br /> Type of Turbine Control Relays: Make FE F t ro Model IST UR <br /> 5 Type of Line Leak Detection: Lj.Mjechanlcal ELf}/CPT ✓ PLLD <br /> PERFORMANCE TEST <br /> 6 Does the E-Stop shutdown power to the DISPENSERS X <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)? X <br /> 9 Are the DISPENSER BREAKERS clearly identified/labeled? X <br /> 10 Are the TURBINE BREAKERS clearly identified/labeled? X <br /> 11 Are all the ESOs accessible and clearly identified/labeled? X <br /> 12 Did the ESO(s)function correctly(de-energized from either the 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 <br /> Site Manager of the problem,place an"Out of Service"Tag on the ESO(s),and identify an alternate mean(i.e., locate <br /> circuit panel,clearly identify turbine and dispenser breakers for shut-off in the event of an emergency). <br /> 12® 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. x <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 /> COMMENTS <br /> Submit completed copy with other documentation In E-Malmonance. <br />