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by GR Job IF 20-640046 Emergency Shut-Off (ESO) Testing Results & Chec i BtCE�VED Facility Infonnation. Contractor Information TEST Reaults Site# 2186 Co. Name: Gettler-Ryan Inc. Date: 1!7/2016 Address: 3212 N California Phone 925-551-7555 City/St: Stockton,CA Lead Technician: Tim Adams x PASS ENVIRONMENTAL eMaint.W.O.# 10007888 Name: or Passport: FAIL(Next Day Repair Required) DPARTME f Signature The objective of this test is to provide assurance that the when the E-Stop switch Is activated,all the fueling system circuits(turbines,and dispensers)are de-energized,and remain de-onergized until they are re-set manually). The test procedures and guidelines shall be In accordance with the E-Stop Testing Process. # The following Information is to bt completed. x To solea Yes no WA SITE DATA 1 Number of E-Stop switches: 1 2 Type of Switch? Push Pull X Momentary_ Plain light/Toggle— Other: (if Momentary type,locate and identify re-set button): In Elect Room 3 Type of Turbine Control Relay System(Electrical Distribution Center): Brown Box Power Solution X Other Custom Fabricated 4 Tye of Turbine Control Relays: Make Red Jacket Model Flow Controller 5 Type of Line Leak Detection: Mechanical ELD/CPT X PLLD PERFORMANCE TEST 6 Does the E-Stop shutdown power to the DISPENSERS x 7 Does the E-Stop shutdown power to the TURBINES x 6 Is the 220 voltage to the turbine relay removed(either the line side or the motor side of the contacts or the coil)? x g Are the DISPENSER BREAKERS clearly identified/labeled? x 10 Are the TURBINE BREAKERS clearly identified/labeled? x 11 Are all the ESOs accessible and clearly identified/labeled? x 12 Did the ESO(s)function correctly(de-energized from either the line side or the motor side of the contacts or the coil)? x 12A If#12 is NO, briefly describe what was wrong: 129 How was it corrected: 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). 121) Elite Customer Solution Center has been contacted for the repair. eMaint.W.O.Ticket# POST TEST 11 Site's fueling system is fully operational. x :1 12 All equipment secured and any access ports, lids,enclosures are closed. x 13 All safety barricades,and any debris was been removed. x COMMENTS Submit completed copy with other documentation In E-Maintenance.