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UST EQUIPMENT MONITORING LOG <br /> Facility Number: Chevron Station# MonthNear <br /> Equipment: VEEDER-ROOT TLS-350 <br /> Equipment Alarm Status <br /> Date Operational? O.K.? <br /> (Green Light On) {All functions Normal} <br /> Comments jitials <br /> 01 Yes 21 No ❑ Yes ❑ No GY 00 G.CUuh-' N t'02 Yes E� No ❑ Yes ❑ No C 1 . \/G�V 03 Yes d No ❑ Yes ❑ NoVl- C V '� <br /> 04 Ye_s_G No ❑ Yes ❑ No h/o \JkL <br /> 05 Yes No ❑ Yes ❑ No No V RX <br /> 06 Yes No ❑ Yes ❑ No ❑ <br /> 07 Yes No ❑ Yes ❑ No ❑ <br /> 08 Yes"'9 No ❑ Yes ❑ Nob NO Q D CC <br /> 09 Yes No ❑ Yes ❑ No �,( NO -\f <br /> 10 Yes ❑ No ❑ Yes No / vQ-C <br /> 11 Yes No ❑ YesV No ❑ Cl . <br /> 12 YesT9 No ❑ Yes [] No ❑ jI co G` hJ <br /> 13 Yes No ❑ Yes 6 No ❑ }\j Aj <br /> 14 Yes No ❑ Yes No ❑ <br /> 15 Yes Ll No ❑ Yes No ❑ , <br /> 16 Yese No ❑ Yes Q No ❑ <br /> 17 Y ks No ❑ Yes No ❑ <br /> 18 Yes No ❑ Yes No ❑ C ,�' . (v <br /> 19 Yes Q No ❑ Yes q No ❑ <br /> 20 Yes No ❑ Yes No ❑ <br /> 21 Yes No ❑ Yes No ❑ N11 <br /> 22 Yesfil No ❑ Yes ] No ❑ <br /> 23 Ye-,,q No ❑ Yes\G] No El <br /> 24 Yes No ❑ Yes No ❑ <br /> Yes No ❑ <br /> 25 Yes EI No ❑ -- --- - - - - —� <br /> i <br /> 26 Yes%,0 No ❑ Ye No ❑ <br /> No ❑ Yes No ❑ <br /> 27 Yes ---- <br /> 28 Yes No ❑ Yes W No ❑ � <br /> 29 Y s No ❑ Yes ❑ No VCQ <br /> 30 Yes No ❑ Yeses No ❑ <br /> 31 Yes ❑ No ❑ Yes ❑ No ❑ <br /> • In 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 Lod, track your activities until "All Functions Normal" is <br /> displayed on this monitoring system console. Retain all alarm condition,test reports and repair work orders related to <br /> each aLIT91. <br /> 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 /> Manager Review (Signature) <br /> Date: � � 1,9,15 <br /> � <br /> Revision Date: August 2011 <br /> Document Owner: Retail OEMES <br />