Laserfiche WebLink
415 t 01he- Site #; Service jYder#: 7yS�X¢� ' <br /> V ii <br /> mp <br /> Address: .r zty/st: tip,, x <br /> 4 <br /> . 4400E. WA'TERLW:: ab, � Say O �„ f'(,)N� CA � �` 952PZ= <br /> , <br /> { <br /> The fal,icw,ing" itrems must be signed `for prior , to starting tank and/or <br /> 1 in. ,tett ing 'at :sites <br /> ,a <br /> K. 17 The location representative understands that PRIOR OR t o FUEL DROPS the Un i t <br /> Manager MUS t stop testing and place thdi' complete station bark into w0r "i ,g <br /> order . <br /> Zv:.The location representative understands that the pumps, dispensers, <br /> electrical supply must- stay disabled throughout the test. , <br /> ) All associated power breakers have been turned off for testing. <br /> 4 : <br /> 4) Magnetic signs have been placed on power breaker boxes. <br /> ra Out of Service bags are on ,dispens.er nozzles. <br /> s <br /> 67 Padlocks are on dispenser nozzles. <br /> Check valve is. closed. 'V <br /> 17 <br /> :> 1ayonet conect'�ar 'is disconrtm.. <br /> 'tdt'e ! fro ., �tm <br /> crp• u ; <br /> 3) All 'safety procedures, have .beendiscussed with all station personnel ., <br /> Location Representative and'` Tanknology Unit Manager have-each confirmed r <br /> that the Tag and Lock-cut procedures are in effect . <br /> The Location Representative agrees that the above items were explained <br /> F and completed prior to the start of Tank and/or Line Testing. <br /> Location Representative's Name-., Loc. Rep. Signature: Date: <br /> Unit Manager Have: Unit Mgr. Signature: Date: 7. <br /> PATR I CK PFRANG <br /> lee <br /> f k <br /> 4 <br /> 3 <br /> Aldk AIC]LOt Y UNDER idAUlVta ASC T ETtwCTTON 'a'll$TEI"1 ".• V6.�?:L > Pa'e r� <br /> -IE.VRl7N Ne 5x174709 - Apr 16, 1996, 1.,53 <br /> K <br /> s. r . <br />