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dPilot/ Flying J — Lodi #617 V PERAT�RS OF SOUTHERN CAUfORNt* ®Mr M/g Daily WT Sotem • Month: Year: r Rev. 1 ., iJ am ❑ pm ❑Siren OK .-©All bulbs light -O Printer works ® AFN* 11 On-going alarm(s) P' 2 ; " , _ : p ❑ pm ,0 -Siren OK 0 A11 bulbs light - O Printer works -® AFN* ❑ On-going alarm(s) 3 ,�;�' am ❑ pm Iren OK albs lightrinter works J20W ❑ On-going alarm(s) 4 ?°7 ❑ aW 0-prn q.Siren OK O*rbulbs light O -Printer works N* ❑ On-going alarm(s) —� 5 am ❑ pm en OK II _bulbs light ET15rinter works FN* ❑ On-going alarm(s) 8 6 w) .Siam ❑ pm EJ Siren OK ll bulbs light ErPrinter works N* ❑ On-going alarm(s) 7 Cl am ❑ pm EI -Siren OK .❑ All bulbs light .❑ Pnnter works 13-ArN* ❑ On-going alarm(s) 8 "., ;° ..❑ am ❑ pm -❑ Siren OK . CYAII bulbs light Ea -Printer works �❑ 13 -AW ❑ On-going alarm(s) 9am ❑ pm Q -Siren OK Y ❑All bulbs light Printer works .❑ AFN* ❑ On-going alarm(s).. t 10 Pram ❑ pm iren OK 1 bulbs light Q.PrlTiter works FN* ❑ On-going alarm(s) 11 ,yam ❑ pm Siren OK DCII bulbs light rinter works ,0 * ❑ On-going alarm(s) '— ' 12 " :- ml E -am ❑ pm JO -&en OK E-AtlYulbs light nnter works N* ❑ On-going alarm(s) ;y -' 13 ! , t_? '`) ❑am ❑ pm Q -Siren OK . ❑ All bulbs light ❑ Printer works ❑ AFN* E3 On-going alarm(s) 14 "`> "' ❑ am ❑ pm 111 Siren OK 11 All bulbs light ❑ Printer works ❑ AFN* ❑ On-going alarm(s) 15 © am ❑ pm ©Siren OK 17'AN bulbs light ❑Printer works —aAFN* ❑ On-going alarm(s) 18 ; ; , ❑ am ❑ pm O -Siren OK P All bulbs light ❑ Printer works PAFN* ❑ On-going alarm(s) 17 F.;'" ❑' am ❑ pm Siren OK [�`AN bulbs light ❑Printer works ' _❑ AFN* ❑ On-going alarms) ' 18 qi l m ❑ pm 200iren OK 12111 bulbs light Winter works * ❑ On-going alarm(s) 19 ❑ am O.Tm U -Siren OK 0-AlMulbs light ❑-Printer works ❑ On-going alarm(s) _ 20 0 ❑-artt"' ❑ pm -E'Slren OK ❑.A rbulbs light B inter works DAFNr ❑ On-going alarm(s) 21 ❑ pm iren OK fd'Alfbulbs light worksN* ❑ On-going alarms) 22 L1,, t70am ❑ pm 'ire OK _121 All bulbs light Winter works FN* 11On-going alarms) 23 j � �m ❑ pm Siren OK SII bulbs light • 6,Printer works ❑ AFN* n -going alarm(s) � _ t , �� ,,,tY6m ❑ pm PZren OK -0A l bulbs light !Printer works - AFN* ❑ On-going alarm(s) � am ❑ pm iren OK ,� All bulbs light rinter works N* ❑ On -gang alarm(s) d251, '( [gym ❑ m P Q -Siren OK ❑ A albs li ht _80 g 0-PMe—' works C�-AFtV* ❑ On- oin alarms 9 9 {)tit i�^''dm ❑ pV ❑ Sttn OK UAll-bulbs light E LPdnter works N* ❑ On-going alarm(s) 28 Q JI&M. pm Q -Siren OK B -N bulbs light O-PrMter works Q-AfN* ❑ On-going alarm(s) . 29 b� ❑ `am . ❑ pm O Siren OK . ❑ All bulbs light O Printer works ❑ AFN* ❑ On -gang alarm(s) 30 ❑ pmiren OK Pa All bulbs light mer works * ❑ On-going alarm(s) 31 ❑ am ❑ pm rO Siren OK ❑ All bulbs light ❑ Printer works ❑ AFN* ❑ On-going alarm(s) * AFN = ALL FUNCTIONS NORMAL (no current alarms) Instructions: Press the alarm test button on the UST monitoring system (MS) and record the results under the 'Daily Monitoring System Test Results' column. If there are no current alarms, check the "AFN" box. If an alarm is occurring at the time of the daily MS test, check the "On-going Alarm(s)" box and record the sensor ID(s) and the alarm panel screen reading(s) under the Win Alarm, Screen Reads:" column. Complete the separate UST System Alarm Response tog for each MS environmental alarm noted (all alarms except "Paper Out" or "Fuel Delivery Needed), Only a trained "Facility Employee" should complete this form or the Alarm Response Log, The FE should initial each entry made into this form using the last cmlumn.