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.14 <br /> ° <br /> �" n <br /> CHEVRON 92033 174705 . <br /> 508 W. CHARTER WAY ST�CKTON, CA 9520�- <br /> The followincn-� items must be signed for prior to starting tannd/or <br /> line testing at site: <br /> 1 ) The lccation reprzssntative un��rst��ds that P�I�R to �i��L �R��S t�e Unit <br /> Manager mus� stop t�s� in� and p� ace the compl �te ststion bac � into working <br /> order . <br /> 2) The location represenve ��de�st �nds ��at t�e puaps, �ls�e�ssrs and <br /> electrical supply must stay disa�� ed ����oughout the <br /> / <br /> 3) All as�ociated pnver breakprs �ave �een tsrned off for testi�g. <br /> 4) Magnetic signs have been p� ace� on powe� breaker boxes' <br /> 5) Out of Ce'vice bags are on dispense' nozzlas. <br /> 6) Padlocks are on dispaoser nozzles. <br /> 7) Check va� ve is c ] ose�. <br /> 8) Bayonet ccnnecto~ is d� sconnected �ro� p:m�F <br /> 9) All safety proce�ures here bee� discusse� with a1 ] sta� ion persocnel . The <br /> Location Representa� jva and TankncIogy Unit Mena�er have eac� confirmed <br /> that the Tag <br /> Cl Lockout procedurss are in effect . <br /> The Locaticn Representative agrees that the above items were explained <br /> and complete6 'pr J, 1, to the start of Tank and/or Line Tes� ing . <br /> Lo�a�inn �yyrpsenta�ie/� ��e� Lm. ���. S�qoa�u/e� Date/ <br /> � <br /> Unit Kuoager Namen �ce� <br /> PATRIC� PFRANG <br /> 1f"ll f, <br /> ' <br />� <br />