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_ n <br /> be <br /> w f lip MIA* b to starting*,,tank andlc�r <br /> V <br /> €'`r.pi eee tt at i vee un v,r t hit t P I Q cr FUEL DROPS t Fie Uhl, <br /> .. <br /> g d placed t'he ;complete station back into-'Wor 3r,� <br /> in er must t t t 'et i n an y <br /> g. <br /> order <br /> >. <br /> The, location; representative Lt,nder stands fh t the pumps, dispensers ,:a�AII,' <br /> "electricaluopI ' must -stay disabled throughout the test. : <br /> 3:►, All associated power: breakers have been 'turned ofi:f for testing. <br /> m "14) Magnetic signs hAve be-sin pIaaC ed on power breaker boxes. <br /> 5) `'Glut of Service bags are on,rdispenser no;,zIes. k7, <br /> 6) Padlocks are on d i sp'enser. nom:lest <br /> r �-,Check valve <br /> is closed. <br />{ 8) Bayonet 'tonnector is di sconnec ted . from pump. <br /> .9) A <br /> All safety procedures; have been discussed with all station personnel . <br /> Location Representative and . Tanicnology Unit Manager have each confirm <br /> i, thst the Tap and Lockout prc�ced�.4rer in effect . <br /> The Location Representative agrees t:haitthe above items were explained,-, <br /> h and completed prior to the start of TAnk and/or Lane Testing. <br /> k <br /> location Representative's Nage:- Loc. Rep. Signature: - hate: <br /> eager Nam: - unit Mgr. Signatures 15 Date: <br /> PAT-R I CW',PFRANC3 <br /> 1 - , <br /> t. 4A Tli ,t�{ <br /> r 4- <br /> Via -a <br /> f =: a <br /> a <br /> e <br /> TANxN00QY - UNO MFAQ --LEAK- �, <br /> EV 1 - <br /> ! N 496-15-174705 Apr li, 1"4� i t48 <br /> Sit is <br /> SerY10Ed <br /> ''�r eri�: � _ -• <br />