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by GR Job# 18201786 <br /> Emergency Shut-Off (ESO) Testing Results & Checklist <br /> _ %0) <br /> Facility Information Contractor Information TEST Results <br /> Site#Arco 7148 Co. Name: Gettler-Ryan Inc. Date:0 6/19/2 018 _ <br /> Address: Phone 925-551-7555 <br /> 3400 N MacArthur Dr Lead Technician David Rouse x PASS <br /> City/St:Trac CA Name: or <br /> eMaint.W.O.# 1? S 2 Passport: FAIL(Next Day Repair Required) <br /> Si nature <br /> The objective of this test is to provide assurance that the when the Estop switch Is activated,all the fueling system circuits(turbines,and dispensers)are de-energized,an <br /> remain de-energized until they are reset manually). The test procedures and guidelines shall be In accordance with the Estop Testing Process. <br /> # The following Information Is to be completed. x Te 3.1 ct <br /> Yes N---rNIA <br /> SITE DATA -' <br /> 1 Number of E-Stop switches: 1 <br /> 2 <br /> 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 X Power Solution Other Custom Fabricated <br /> 4 Type of Turbine Control Relays: Make a_PETRQ Model V C <br /> 5 Type of Line Leak Detection: Mechanical ELD/CPT ✓ PLLD <br /> PERFORMANCE TEST <br /> 6 Does the E-Stop shutdown power to the DISPENSERS <br /> 7 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)? 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? )( <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 /> 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 /> 12D 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 /> AL 13 2018 <br /> Submit completed copy whh other documentation In EWalrtonance. <br /> TH t)>=p�•FtT�� <br />