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Emergency Shut-Off (ESO) Testing Results & Checklist Facility Information Contractor Information Test Results Site# 6080 Co.Name: FASTECH Date:03/12112 Addr. 85 Louise Ave. Phone: 714-523-0194 City/St:Lathro ,CA Lead Tech: Isaac Anderson Alltech Petro) ✓ PASS eMaint.W.O.# 9814211 Name: Isaac Anderson Alltech Petro) or Pass ort#: B36878 FAIL(Next Day Repair Required) Signature: The objective of this test is to provide assurance that when the ESO switch is a v all t f eling system circuits(turbines,and dispensers)are de- energized,and remain de-energized until they are re-set manually. The test pr(ce ures and guidelines shall be in accordance with the ESO Testing Process. X To Select # The following information is to be completed. Yes No NIA SITE DATA 1 Number of ESO s- 1 2 Type of Switch Push Pull Monentary111 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 Fabricate( :..; Carolina Box ✓ Other 4 Type of Turbine Control Relays: t✓. Make FE Petro Model ist-VFC 5 Type of Line Leak Detection: Mechanical ELD/CPT ✓ PLLD PERFORMANCE TEST 6 Does the ESO shutdown power to the DISPENSERS? J 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 ✓ 8 coil)? 9 Are the DISPENSER BREAKERS clearly identified / labeled? / 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 J 12 or the coil)? 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). Elite Customer Solution Center has been contacted for the repair. 12D eMaint.W.O.Tick POSTTEST 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. J COMMENTS Submit completed copy with other documentation in E-Maintenance.