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UST EQUIPMENT MONITORING LOG <br /> Facility Number: Chevron Station# 96171 Month/Year <br /> Equipment: VEEDER-ROOT TLS-350 <br /> Equipment Alarm Status O.K.? <br /> Date Operational? {All functions Normal) C0111I11eI1tS Initials <br /> {Green Light On} <br /> 01 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 02 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 03 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 04 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 05 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 06 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 07 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 08 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 09 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 10 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 11 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 12 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 13 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 14 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 15 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 16 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 17 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 18 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 19 Yes ❑ No ❑ Yes ❑ No❑ <br /> 20 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 21 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 22 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 23 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 24 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 25 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 26 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 27 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 28 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 29 Yes ❑ No ❑ Yes ❑ No ❑ <br /> 30 Yes ❑ No ❑ Yes ❑ No ❑ <br /> ZIn31 Yes El No ❑ Yes ❑ No El the case of alarms, (audible alerts,warning and alarm system lights), system failure,tear off the Alarm Condition <br /> Report printout from your monitoring system printer and document the alarm condition under the appropriate <br /> category listed above.Using the Suspected Leak Activity Log,track your activities until"All Functions Normal" is <br /> displayed on the monitoring system console. Retain all alarm condition,test reports and repair work orders related to <br /> each alarm. <br /> Q File the completed log with the UST Inventory Reconciliation Logs in the appropriate Month of your station's Retail <br /> Facility Compliance(RFC)Management Workbook <br />