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by GR Job# 20-630005 <br /> Emergency Shut-Off (ESO) Testing Results & Checklist <br /> Facility Information Contractor Information TEST Results <br /> Site# Arco SS 2186 Co. Name: Gettler-Ryan Inc. Date: 1/13/2015 <br /> Address: 3212 N.California Phone 925-551-7555 <br /> Ci /St: Stockton CA Lead Technician: Chris San Nicolas x i PASS <br /> eMaint.W.O.# 9960043 Name: or <br /> Passport: FAIL(Next Day Repair Required) <br /> Si nature <br /> 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 <br /> remain de-energized until they are re-set manually). The test procedures and guidelines shall be in accordance with the E-Stop Testing Process. <br /> # The following information Is to be completed. x To s.1.n <br /> r.. No run <br /> SITE DATA <br /> 1 Number of E-Stopswitches: <br /> 2 Type of Switch? Push Pull x Momentary_ Plain light/Toggle_ Other: <br /> (if Momentary type,locate and identify re-set button): In Elect Room <br /> 3 Type of Turbine Control Relay System(Electrical Distribution Center): <br /> _Brown Box Power Solution x Other Custom Fabricated <br /> 4 Type of Turbine Control Relays: Make Red Jacket Model Flow Controller- <br /> 5 Type of Line Leak Detection: Mechanical ELD/CPT x PLLD <br /> PERFORMANCETEST '� <br /> 6 Does the E-Stop shutdown power to the DISPENSERS x <br /> T Does the E-Stop shutdown power to the TURBINES x <br /> 8 Is the 220 voltage to the turbine relay removed(either the line side or the motor side of the contacts or the coil)? x <br /> 9 Are the DISPENSER BREAKERS clearly identified/labeled? x <br /> 10 Are the TURBINE BREAKERS clearly identified/labeled? x <br /> 11 Are all the ESOs accessible and clearly identified/labeled? x <br /> 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 <br /> 12A If#12 is NO, briefly describe what was wrong: <br /> 12B How was it corrected: <br /> 12C If repair or ESO functionality cannot be corrected same day(prior to leaving the site). The technician MUST notify the Site <br /> Manager of the problem, place an"Out of Service"Tag on the ESO(s),and identify an alternate mean(i.e.,locate circuit <br /> panel ,clearly identify turbine and dispenser breakers for shut-off in the event of an emergency). <br /> 12D Elite Customer Solution Center has been contacted for the repair. <br /> eMaint.W.O.Ticket# <br /> POSTTEST <br /> 11 Site's fueling system is fully operational. x <br /> 12 All equipment secured and any access ports, lids,enclosures are closed. x <br /> 13 All safety barricades,and any debris was been removed. x <br /> COMMENTS <br /> FEB 10 201b <br /> Submk completed copy with other documentation In E-Maintenance. `a <br />