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ppppp- <br /> Maintenance/Repair Log and site Name: <br /> ISb Alarm Log City: S: <br /> Date/Time ISD Alarm Date/Time Technician Information Date/Time <br /> as Indicated I . Date of Component Service Performed and the <br /> Problem on Console Service Call Services Name,Affiliation, Phone Y---nber and Removed Outcome? <br /> Discovered (if applicable) I Mad * Certification Numb4 from Service <br /> y-,,� AP(' Ove rNcu�y- <br /> SM t �U- �� 1AA , Z 0 d o VQ <br /> '� Cpm, Uc 5� I <br /> (S° ' yr S <br /> 76�T37o z, z�2or� �Is�M .c� � uej <br /> fi-e571rt a 7o fe T' <br /> rn <br /> rn <br /> C <br /> K <br /> Mr o <br /> Z <br /> M <br /> 'Record date and time any vapor recovery equipment problem (damaged or defective equipment or ISD alarms)was discovered. <br /> 2Record the name of the ISD alarm as it reads on the ISD console. <br /> 3Record date and time the service call was made. <br /> 5Record date and time service was perfonmed. <br /> Record certified repair technician's name,company affiliation, phone number and certification number from applicable manufacturer. <br /> 6Record date and time component was taken out of service, if applicable. <br /> 7Record brief explanation of service performed, including outcome of service (repaired,tested and returned to service,waiting for parts, etc). Any and all actions <br /> taken to identify the cause of an ISD alarm,including the actual results of tests performed in accordance with the IOM requirements for that alarm(results <br /> may be attached),must also be noted here or In supporting documents. <br /> Rev. 8/20/12 <br />