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COSTCOEmergency Stop Switch Operation Inspection WHOIESME Facility: Costco # 1031 Manteca Date : 03/10/20 Address : 2440 Daniel St. Testing Company : Alltech Petro Inc. City, State , Zip : Manteca , Ca Tester Name : Isaac Anderson This procedure is to verify the operation of all emergency stop switches/buttons ( E-stops ) . Each &Stop must disconnect power to the dispensers , submersible turbine pumps (STPs ) and all non-intrinsically safe electrical equipment in classified areas . Test each E-Stop separately. See PEI /RP1200 , Section 11 for the inspection procedure . E-Stop Number or ID 1 2 3 Location On Data Hut South side of Station 1 . E-stop labeled and located ® Yes ❑ No ® Yes ❑ No ❑ Yes ❑ No where easily accessible? 2 . System is fully powered and in ® Yes ❑ No ® Yes ❑ No ❑ Yes ❑ No normal operating condition ? 3 . After activating E-stop , power has been disconnected from : 3a . All dispensing devices on all ® Yes ❑ No ® Yes ❑ No ❑ Yes ❑ No islands? 3b . All STPs for all fuel grades? ® Yes ❑ No ® Yes ❑ No ❑ Yes ❑ No 3c. All power, control and signal circuits associated with the ® Yes El No ® Yes [:1 No El Yes El No dispensing devices and the STPs? 3d . All other non-Intrinsically safe electrical equipment in classified ® Yes El No ® Yes E] No El Yes [:1 No areas surrounding fuel dispensing devices ? 4 . All intrinsically safe electrical equipment remains energized ® Yes ❑ No ® Yes E] No El Yes El No after E-stop activation ? 5. After testing , has E-stop been ® Yes ❑ No ® Yes ❑ No ❑ Yes ❑ No reset and power reestablished to normal operating condition ? A " No" to lines 3a-3d indicate a test failure . Test Results : ® Pass ❑ Fail ® Pass ❑ Fail ❑ Pass ❑ Fail Comments : 207 `1 ENVIRONMENTAL HEAL TH Tester's Signature Date : 03/10/20 DEpARTMENIT II