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by Emergency Shut-Off (ESO) Testing Results & Checklist Facility Information ` Contractor Information Test Results ' Site# 12186 Co. Name: FASTECH Date 02/22/11 Addr. 3212 N.Califomia Phone: 714-523-0194 CitylSt:Stockton CA Lead Tech: Omar Ruiz PASS eMaint.W.O.# 9740062 Name: Omar Ruiz or Pass ort#: 9740062 FAIL(Next Day Repair Required) Si nature: ' ' The objective of this test is to provide assurance that when the ESO switch is activated,all the fueling system circuits(turbines,and dispensers)are de- energized,and remain de-energized until they are re-set manually. The test procedures and guidelines shall be in accordance with the ESO Testing Process. # The following information is to be completed. X To Select Yes I No N/ SITE DATA 1 Number of ESO switches: 1 2 Type of Switch ✓ Push Pull ❑Monentary ❑Plain light/Toggle ❑ Other if Momentary type, locate and identify re-set button): 3 Type of Turbine Control Relay System(Electrical Distribution Center): Brown Box Power Solution Custom Fabricated ❑ Carolina Box ✓ Other 4 Tvpe of Turbine Control Relays: Make red jacket Mode cot 5 Type of Line Leak Detection: Mechanical ✓ ELD/CPT PLLD PERFORMANCE TEST 6 Does the ESO shutdown power to the DISPENSERS? ✓ 7 Does the ESO shutdown power to the TURBINES? ✓ ❑ Is the 220 voltage to the turbine relay removed(either the line side or the motor side of the contacts or the coil)? ❑ ❑ 8 9 Are the DISPENSER BREAKERS clearly identified/labeled? J 10 Are the TURBINE BREAKERS clearly identified/labeled? ❑✓ ❑ 11 Are all the ESOs accessible and clearly identified/labeled? Did the ESO(s)function correctly(de-energized from either the line side or the motor side of the contacts or the coil)? O El12 If#12 is NO, briefly describe what was wrong: 12A How was it corrected: 12B 12C If repair or ESO functionality cannot be corrected same day(prior to leaving the site). The technician MUST notify the Site Manager of the problem, place an"Out of Service"Tag on the ESO(s),and identify an alternate mean(i.e., locate circuit panel ,clearly identify turbine and dispenser breakers for shut-off in the event of an emergency). 12D Elite Customer Solution Center has been contacted for the repair. eMaint.W.O.Ticket# POST TEST_ 11 Site's fueling system is fully operational. ✓ 12 All equipment secured and any access ports, lids,enclosures are closed. J 13 All safety barricades,and any debris was been removed. ✓ COMMENTS Submit completed copy with other documentation in E-Maintenance.