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by GR Job# 18201728 <br /> 0 Emergency Shut- (ESO) Testing ResultsChecklist <br /> t. <br /> Slte#Arcg 5450 Co. Name: Gettler-Ryan Inc. Date:7/19/2018 <br /> Address: Phone 925-551-7555 <br /> 1617 W. Fr mont Lead Technician:David Rouse x PASS <br /> tYI st:Stockton,CA Name: or <br /> eMalnt # Pas ort: I IFAIL(Next Day Repair Required) <br /> ISignature <br /> The objective of this test is to provide assurance that dee when the E.4top switch Is activated,all the fueling system circuits(turbines,and dispensers)are de-energized,an <br /> remain deenergLzsd until they are re-set manually). The test procedures and guidelines shall be In accordance with the Estop Testing Process. <br /> # The following Information Is to be completed <br /> X To sweet <br /> - <br /> Qy w <br /> + Number of E-St switches: <br /> 2 Type of Switch? Push Pull.0 Momentary Plain tight/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 M Power Solution Other Custom Fabricated <br /> 4 Type of Turbine Control Relays: Make Model MAG VFC <br /> 5 le of Line Leak Detection: Mechanical ELD/CPT PLLD <br /> ,:: Tom► 97 WAST <br /> Does the E-Stop shutdown power to the DISPE S. <br /> T Does the E-Stop shutdown power to the TURBINES <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 /> 9 Are the DISPENSER BREAKERS clearly identified/labeled? <br /> 10 Are the TURBINE BREAKERS clearly identified/labeled? <br /> 11 Are aU the ESOs accessible and dearly identified/labeled? <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)? <br /> 12A If#12 is NO,briefly describe what was wrong: <br /> 1-29 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 aftemate mean(i.e.,locate <br /> circuit panel,dearly identify turbine and dispenser breakers for shut-off in the event of an emergency). <br /> 12D Elite Customer Solution Center has been contacted for the repair. <br /> eMaint.W.O.Ticket# <br /> 11 Site's fueling system is fully operational. x <br /> 12 JAII equipment secured and any access ports,lids,enclosures are dosed. x <br /> 13 JAII safety barricades,and any debris was been removed. x <br /> 2 2 € <br /> AUG 16 2108 <br /> ENVIRONMENTAL <br /> HEALTH DEPARPMENT <br /> Sutmdt completed copy with other documantetion In E-Malnteeance. <br />