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Work Order: 2272558 <br /> by <br /> Emergency Shut-Off(ESO) Testing Results & Checklist <br /> Fadlitty Infotmadon Contrill Infotmstlon Test <br /> iM# o.Name - Data: 7 yr f <br /> ddress, V C411 ,01 hone'. <br /> St:C ad T nKW._ ASS <br /> Maint.W.O.# <br /> AIL(Next Day Repair Required) <br /> naturF"— <br /> The <br /> uOMc&r of V&bar M to Pra'/rde rmMXrrnq that wh—the ESO*W teh Y actrrald,as IW raNtna eyatem dreesa(t NN,.e.and diepen.anl•n deenrytmd,•nd—Iri d—I fyl <br /> tMy am n t rrwnkny. The Wt Prt'catkimiis and euk"ivis aMs be M accordance vdth the ESO'reeikq Prods. <br /> I T.1—i,t M&.*p frrfora»dm Is lob.cowplrMal <br /> DATA <br /> t lNumtrier of ESO switch <br /> 2 ype of Switch. ush Nil _Momentary Plain ligh Toggle _Other(__ __ ) Y b » <br /> � .W <br /> (if Momentary type,locMte and identify re-Sel button)' <br /> 3 Type of Turbine Control Relay System(Electrical Distri on Center): <br /> _&own Box _ Power Solut on ustom Fa 'cated Carolina Box Other <br /> _ C4ti 'z <br /> 4 Type of Turbine Control Relays. Make Model <br /> 5 Typeof Line Leak Detection. Mechanical LDICPT PLLD <br /> pRYANCE TEST <br /> 6 oes the ESO shutdown power to the DISPENSERS? <br /> 7 roes the ESO shutdown power to the TURBINES? <br /> 8 s the 220 voltage to Te turbine relay removed(either the line side or the motor side of the contacts or the coil)? <br /> 9 the DISPENSER BREAKERS dearty identified I labeled? <br /> 10 Ke the TURBINE BREAKERS clearly identified i labeled? <br /> 11 s all the ESOs accessible and dearly identified I labeled? <br /> 12 id the ESO(s)function correctly(de-energized from either the line side or the motor side of the contacts or the coil)? <br /> 12A f#12 is NO,briefly describe what was wrong. <br /> 12R iow was it corrected <br /> 12C f repair or ESO functionally cannot be corrected same day(prior to leaving the site). The technician MUST notify the Site <br /> Hager of the problem,place an"Out of Service'Tag on the ESO(s),and identify an a0.emate mean(i.e.,locate circul panel <br /> earty identity turbine and dispenser breakers for shut-oli In the event of an emergency) <br /> 12Drsalety <br /> er Solut on Center has been mntacled for the repair. <br /> .Ticket# <br /> T <br /> 11g system is fuly operabonai <br /> 12nt secured and any access ports,lids,enclosures are dosed t? ' <br /> 13rricades,and any debns was been removed. <br /> COM11111i <br /> 9rr oaaapaaad copy wrM air dssrwrYl.n ti EalYYdwanc� <br /> Tanknology Inc. 11000N.MoPac Expressway,Suite 500,Austin,Texas 78759 <br />