DERR-2024-006940

4-
Stete o-'t]mh
n
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
Michael O. l,eavitt
Govemor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Dirertor
168 North 1950 west
P.O. Box 144840
Salt Lake City, Utah 841 14-4840
[phone]
[phone] Fax
[phone] T.D.D.
www.deq.state.ut.us Web
rILE. CtlPI
ERRU-218-01
December 11,2001
Tammy Brendel
BP Amoco Oil Corporation
P.O. Box 15748
Shawnee Mission, Kansas 66285-5748
RE: Underground Storage Tanks (USTs)
Located at Rainbo Station #46,36t2 West 4700 South, West Valley City, Utah
Facility Identification No. 4001576,3 Tanks
Dear Ms. Brendel
A review of the information you have submitted in the closure notice received on
April 30, 2001 for the above referenced UST(s), indicates that no corrective action is required at
the site at this time. The information you have submitted indicates that any detectable petroleum
contamination at the site complies with state UST rules. Based upon these rules, there appears to
be no threat to human health or the environment.
' Corrective action may be needed in the future if contamination is found that threatens
human health or the environment. Please contact Paul Harding at [phone] if you have
any questions regarding this matter.
Sincerely,
Kent P. Gray,Secretary (UST)
Utah Solid and Hazardous Waste Control Board
KPG/PRIVhsp
cc: Bennett Leeper, Delta Environmental
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box 144840
salt Lake city, utah 84114-4840
(801) s36-4100
Fax [phone]
Fax [phone]
FAX COVER SHEET
Date
Agencyffirm: l)-L*z' E ,rr,rc'^ rrr c *r ,[
FAX Number: 2b I - *,o LZ
From
Pages to follow:
To
Comments:
s[-*-/av., $Ll(, 3kz \/e-s* v?iD s V' sl Vqril r,T
o49'7
ii
iti
I
I
UNDERGROUND S TAGE TANKPERMANENT CLOSURE N rtCE_(Revise d 0l I 0l I 97)
Facility ID #--ZAOffigf-
Llfd 6+6
RECEIVED
Nov 0 I 2001
DEO
Enriroflmental Response & Romediafion
of (company name) Delta Environmental Consultants, Inc. Phone # [phone]
Address 1030 W. 5370 So.City SLC State UT zip 84123
FACILITY INFORMATION
Tank Owner Amoco Oil Corooration Phone # [phone]
[ ] soleproprietorship [ ] partnership [X] corporation
Address 474 West 900 N,orth City Salt Lake City State zip 84103
Facility Name Rainbo Station #46
State Use Onlv
Samples in LUST File #
Date Mailed to LHD
Date Processed
Samples in LUST Review
LUST Status
Address 3612 West 4700 City West Vallev CiW State UT zip 84 118
Contact person Carl Phone #[phone]
Number of regulated tanks at the facility before closure: 3
Number of regulated tanks at the facility after closure: 0
TAI\KS CLOSED
*Indicate the specific substance stored in each tank to be closed (regular, unleaded, diesel, waste oil, etc.)
TANK REMOVER Name Aaron Spackman Cert.# TR 0039 Exp. date_!{!lQ1
Company
Address Zip 84104
SOILiGROUNDWATER SAMPLER Name Cert# Gslzl2 Exp. date 212002
Company
Address
Wasatch Phone #r 80r)
2240 West Cali Avenue SLC State
Delta Environmental Phone #( 801) 270-9106
Tank #I 2 3
Date Installed 6t89 6t89 6t89
Capacity 1 2000 12000
Substance stored gasoline gasoline gasoline
Date last operated 5t3t/01 5131l0t 5/31t01
Date closed 7t2t0t 7/2101 7/2t0t
How closed
(Removed/In place)
removed removed removed
1030 West 5370 South
Jeffrev Bise:low
City SLC State UT Zip 84r23
Closure Notice prepared at the request ofthe owner/operator (identified below) by Jeffrey Biselow
UT
12000
I
CLdSURE INFoRMATIoN
[ ] Fuel was emptied [ ] Sludge was removed
Tankwas: []Purged [x]lnerted
I x ] Tank was cleaned
Method Used: Dry Ice
For in-Place Closure: tanks filled
For Change-in-Service: Substance to be stored
DISPOSAL SITES USED:
Location Name Contact Name Phone #Date Amount
Tank(s)
Atlas Steel Gale Howe 973-8787 6t28/01
Tank#1,2,3
Product From Tank(s)
NA
Contaminated Water From Tank Cleaning
B&H
Technologies
898-s726 6/25/01 2s0
eal
Sludge
NA
gal
Contaminated Water From Excavation
NA
sal
Contaminated Soil
NA
vd3
Is any contaminated soil which was over-excavated still on-site? Yes X No Not Applicable
Was Free Product encountered during closure activities? No If yes, please indicate thickness, _Inches
SITE ASSESSMENT
Cgmp]eqe the Facility Site Plat (Closure Notice) and.sample Information Table.(Closure Notice) on pages 3 and 4 to show the locations, depths, and
other information on all soil/groundwater samples taken for closure. The samplis must be consistenily-identified by sample ID # on the'sitd plai,
table, and lab analysis report.
I x ] Completed Facility Site Plat (Closure Notice) is attached.
The follow_ing must.be +qtldqa (enter the distance, and direction (N, S, E, W) from the area of contamination from where applicable,
use the OH for overhead, NP for not present):
Water Line
-Sewer
Line _Natural Gas _Storm Drain _Telephone _ElectricalBuildings
I x ] Completed Sample Information Table (Closure Notice) is attached.
I x ] Certified lab analytical environmental sample results are attached.
I x ] Unified Soil Classification (USC) sample results are attached.
I x ] Chain of Custody form is attached.
I x] Sampleswereproperly:[ -JCollected [x ]Labeled [x ]Packaged [x ]TransportedI x ] Samples were in sight of the person in custody at all times or in a secured lScked plice. -
I certify under penalty of law that the closure
?89.52'and280i2) and R311-205 U.A.C., and
R3l l-205-2(a)(1) were properly collected.
site assessment at this facility was conducted in accordance with R31l-202 (narts
that any additional samplesiequired by R3rl-202 parts 280.52 and 280.72'ind
Signature of Certifi ed Groundwater/Soil
FulI name of Certified Jeffrev J Bigelow Date 10123/01
Property Line
If contamination at the facility is confirmed, any person providing
The Certified UST Consultani providing assistance rs:
CERTIFIED UST CONSULTANT Name Bennett Leeper
remedial assistance for a fee must be a Certified UST Consultant.
Cert.# 162 E*p.Date 1212002
#270-9108Company
Address SLC State UT Zip
FACILITY SITE PLAT (CLOSURE NOTICE)
2
103 0 West 5370 South 84123
Facility rD # 4001516 Drawn See Attached Figure Date 10/23101
t
NORTH
Scale: l" : _Feet
The'site plat must be drawn to an
other relevant information, Tank
closure notice
X : Sample location (SS-#, WS-#, USC-#)A: Monitoring Wells (MW-#,)
O = Soil Boring (SB-#), or Geoprobe Boring (GP-#)
O : Water Wells (domestic, livestock, etc.)
Slope of Surface Topography: (N, NW, W, SW, S, SE, E, NE)
Land Use At Site: Residential Commercial Industrial
S u rro u n d i n g Lan d : -_Res i d e n t i a I -_ Commerc i al _ I n d u str i a I
1,
apprc, te identified scale. It must show actual samp^ iocations, substances stored in tanks, and
and sample identification numbers must be consistenf wrth the information given in p. I and 4 of the
Site Plat Must Indicate Actual Locations Of:y' Current & former tanks, piping & dispensers
r'_ Excavations, GW monitoring wells & soil stockpiles
r'_ Location & depth of all samples taken
r'. Buildings, fences, & property boundariesr' Utility conduits (sewers, gas, water, storm drains,
electrical etc.)/ Depth to groundwater (ifencountered)
SAMPLE INFOR}IATION TABLE
3
(Closure Notice)
1
1
Residentiol
e
trosh AMOCO STATION' #+a
CAR WASH
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47OO SOUTH
FIGURE 1
SITE MAP
RAINBO STATION #465612 WEST 47oO SOUTH
WEST VALLEY CITY, UTAH
P.oitrt No.
t 3500E5
Prc?ared by
IJ/SLB
Ororo by
JTIA
LEGEND
ot02030
FIr-=-!
Scole (fcct)
o
o
----w----
----E----
--c-_
----G- ---
MONITORING WELL LOCAIION
SOIL PROBE LOCATON
\,VATER LINE (BuRtED)
ELECTRICAL LINE (BURIEo)
ELECTRICAL LINE (OVERHF}D)
CAALE TELEVISION
GAS LINE (BURIED)
2/./s8
Dote Raicred by
Sso
Frlcmre
r 3500s 'ph^Delta
Envkoomentat
Consdtaots. lnc.
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guollm Sell-XI BTEXN;MBE;-
TPHgro
sr, 14505
gasolino Soil l-4
4506ss-d /grsqlfri Solf l4
ss-, 14507
grrollnc Soil 4 !p[miE-,Jo-Bb..-......-
s$6 /,1108
g83olir6 Soil I A
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guroli!.]-
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ss.8 / a5lo 1 BTlxNME-
-TPHso
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s$t/.51t gprolioc Soll EPA lrtzlD, t0l5b
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gesoiffi-Sofl 1
TP mE2lE-BoB!----
ss-I0 / lJ 11
galolirc Sqil 4
_u5gl B@linc SoiI -_tz NA usc
t sc-,garoline Soil NA usc
EE
St b c€niftrd Irbcebry
Ad&css 4Er Avc,AlEnoDlr SDdnqs StuE_-E!_
Cs ssl Pamon R{n Phdc # (407")
Plcuc lEt"; sy *, r.1 or dftnurrtug cirEurE6lsls arcnE'tqott dudDg tbs ,iE tE5arrEclt of clofurc:
I cc@ unaer penaXy o( ltw ltrat I r[ tt. Orncr oftto trE{t) dcscrlb.{f abovc atrd ahrt I am
fLrlher, tirt tt6 l''oc.dqtt ictcrited
Edllar rith ttc iaformrtioror ltL frrgr ud 6et b tEG. racrrrtc\-ntcnh clotultr
rud complsE rd vctt follotred dwltrg
Slga.hrc of UST
l'dl lrurrG ol Otlcr Iht
Rtllllr corytrEtEd clolut! Not'c€ fonq Flcilrty sits Pl8 lad sarylc lufo,roatirE T.brc, soiyc oonfivarci 6empl6 lab aEilysisrcstdg' USC Eeroplc r6[tts, aDd Challl of Osody fora wilhlo 90 &yr of UsT Closu! to:
Sttrc of Urah TJ€?c of EwimuDGel eorlily
Dlvkiotr of E[viro[.@coBl Rcspouc rnd RcocdiatiqE UsT &stioqr
P.O- .Box 144a0
168 Nonh 1950 Wql
SsIt T 'L. C5b,, Utab t4t 1,r.1&O
4
e/e,a BgeSI9atrA8tr:01
StDrtr[M
.tottd lrrotrl
Soil srExrt MTBH -
TPHcro
EA EO2lb, rorib-
EHA UUZt h tol5b
trTE(N. fTBB.
TPIIco EPA t02rb. gunfi-
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EPA 602th 80ItE-
u
s9tha88gr5 of,oNu dE : t^lodl datr tga raoe-G- no
)/r^Delta
Environmental
Gonsultants, lnc.
1030 West 5370 South
Salt Lake City, UT 84123
801/261 -8006 FAX: [phone]
USC CLASSIFICATION
BY
DATECHECKED
JeffBigelow
SUBJECT
PROJECT NO.1300E5
SAMPLEID
USC I
USC 2
DESCRIPTION CLASSIFICATION
SILTY CLAY, LOV/-MEDITJM PLASTICITY, LIGHT GREY (ML)
SILTYCLAY,MEDIUMPLASTICITY, OLTVEGREY (ML)
I
'R.JECTNRME
Mo.o #46 WESTVALLEYCITY, UTAH
7l2lQL.
a
Date Reported
Project Number
Number
Number
NYSDOH Number
CTDPH Number
NCDEHNR Number
SCDHEC Number
CHTMICAL
LrBOpATOptfS
INCORPORATED
Received From:
Delta Env
1030 w. 5370
Salt Lake City,UT 84
Ju117 2001
AMSWUT-46
13500E5
883018
11595
0l_73
296
9 6019For: DRY WT BASIS BTEXMNBO21 GRO
Date Sampled:,Jul 2 200L Date Received:'Jul 3 2001- Lab Numbers: 4503-4513
REPORT OF ANALYSIS
Parameter
Dilution_Fac!or
cRo-C6-Cl-0 ug/kg
GRO_Spike ug/kg
Unit Reportable tRec tRSD
Detection
r,imit
10.0 94.
1.00 93.
<l_0.
91.
4503
SS1
<l_0.
90.
10.
50.
<50.
<50.
<50.
<50.
<50.
<50.
35.
4504
SS2
l-3.
50.
<50.
<50.
<50.
<50.
<50.
<50.
35.
29.
28.
4505
ss3
1.0
<10.
93.
4506
ss4
4507
ss5
*H20
ug/kg
0.0100
4.20
.280
92
86
05
20
83
04
.4r-0
.980
.l_40
.00 r_05.
;
1
101.
96.6
101-.
135.
81.3
11s.
9s.9
96.8
L.00 1.00 1.00
<50.
<50.
<50.
<50.
<50.
36.
29.
28.
Jefferson L. Flowers, Ph.D
Jefferson S. Flowers, Ph.D
481 NEWBURYPORT Av.
ALTAMONTE SPHINGS
FLORTDA 32715 - 0597BUS: [phone]FAX: [phone]
<50.
<50.
<50.
<50.
<50.
0
9
2
0
0
0
0
0
0
0
5
2
!
9.0
50.
<50.
36.
0
5
I
0
0
0
0
0
0
0
7
4
!
0
0
1
3
0
0
0
0
0
0
0
4
0
:
0
l-
I
0
0
0
0
0
0
0
8
7
^_
<10.
92.
8.9
50.
<50.
r_.00
<l-0.0
94.L
6.83
s0.0
<50 .0
EMoist
Dilution_Factor
Benzene
Ethylbenzene
Toluene
Xylene
Methyl-terL-butyleth
Naphthalene
Surrogate-Spikel-
Surrogate-Spike
Surrogate-Spike
ug
ug
ug
ug
ug
ug
ug
ug
/kg
/kg
/kg
/kg
/kg
/ks
/kg
/kg
l_
1
1
1
L
1
.0
00
00
00
00
00
001
2.
L.
2.
o
4.
2.
<50 .0
<50.0
<50.0
75.4
<50.0
36.2
29.5
28.3
2
i
0
0
0
.0100
.01-00
29.
28.
29
28
Certificate of Result,s
Samp 1e integrity certified prior Lo analysis. Test result,s meet all requirments
of the NELAC St as noted in the QA Report Section 4.
This Report may not , results relate only to items tested
Jefferson Flowers, Ph.D.
President/Technical Director
SecLion 1 of 5 Page 1 of 3
Serving Your Analytical and Environmental Needs Since 1957
^\
Received From: Date Reported :Delta Env.-UT project Number :
1030 W. 5370 South pO Number :Salt Lake City,UT 84123 FLDOH Number :
NYSD0H Number :
CTDPH Number :
NCDEHNR Number :
SCDHEC Number :For: DRY WT BASrS BTEXMN8021 cRO
Date Sampled:,Jul 2 200L Date Received:Ju1 3 2001 Lab Numbers:
REPORT OF A}TALYSIS
rLcltfps
CHfMICAL
1AEDDATODTTS
INCORPORATED
'Ju1L7 2001-
AMSWUT_45
1350085
EB3O1B
11595
0r_73
296
960L9
4s03 -4 513
Parameter
Dilution-Factor
GRO_C6-C10 usr/ksr
GRO-Spike us/ks
Unit Reportable tRec SRSD
Detection
Limit
r_ .00
<10.0
93.7
4508
ss6
10.
50.
<50.
<50.
<50.
<50.
1.00
<l-0.0
92.5
4s10
ss84
451_1
SSB5
1.0
<10.
9l-.
13.
50.
<50.
<50.
<50.
<50.
<50.
<50.
37.
28.
28.
45L2
SS9
1. 001.00
3 790
9L.4
<l_0.
9L.
tMoist
Dilution_Factor
Benzene
Ethylbenzene
Toluene
Xylene
Methyl-tert-butyleEh
Naphthalene
Surrogate_Spikel
Surrogate_Spike2
Surrogate_Spike3
*H20 0.0100
ug/kg
ug /kg
ug/kg
ug/kg
ug/kg
us/ks
uglkg
ug/kg
us/kg
1.00
1.00
1.00
1 .00
L.00
1-.00
0.0100
0.0100
0.0100
105.
101.
96.6
10L.
135.
8r_ .3
115
95.
96.
r.0.0 94 .
r..00 93 .
4.20
.280
2.92
1.86
2.05
.920
4.83
2.04
.410
.980
.l_40
;
I
;
I
, Ph. D.
1 Director
;
0
0
0
0
0
64.6
<50 .0
37.5
29.0
28.3
0
2
1
0
0
0
0
0
0
0
7
9
:
7 .62
s0.0
<50.0
<50.0
<50. 0
<50.0
<50.0
<50.0
36.8
29 .4
28 .4
13.
50.
<50.
<50.
<50.
<50.
<50.
<50.
37.
29.
29.
rQ
0
9
1
0
0
0
0
0
0
0
2
9
!
;
0
0
0
0
0
0
0
4
0
I
1_4.
50.
<50.
<50.
<50.
<50.
<50.
<50.
36.
29.
28.
Certificate of Results
Sample integrity certified prior to analysis. Test results meet all requirmentsof the NELAC Standards , except as noted in the QA ReporL SecLion 4This Report may not be reproduced in part, results relate only Lo items tested
Jeff lowers
PreS /Technica
Section 1- of 5 Page 2 of 3
Jefferson L. Flowers, Ph.D
Jefferson S. Flowers, Ph.D
481 NEWBURYPORT Av.
ALTAMONTE SPRINGS
FLORTDA 32715-0597BUS: [phone]FAX: [phone]
Serving Your Analytical and Environmental Needs Since 1957
45 09
SS7
ruolvfps
CHEATICAL
LIBODATODIEs
INCORPORATED
Received From:
Delta Env.-UT
l-030 W. 5370 South
SaIt Lake City,UT 84L23
Date Reported
Project NumberPO Number
FLDOH Number
JuI17 2001
AI{SWUT-46
13 50085
E8301-8
NYSDOH Number : 11595
CTDPH Number : 0173
NCDEHNR Number z 296
SCDHEC Number : 96019For: DRY WT BASIS BTEXMN802L GRO
Date Sampled:.lul 2 200L Date Received:,Jul 3 2001- Lab Numbers: 4503-451-3
REPORT OF ANALYSIS
4513
SSlOParameter
Dilution_Factor
cRO-C6-Cl-0 ugr/kgr
GRO_Spike ug/kg
Unit Reportable ERec SRSD
Detection
Limit
10.0 94 .2 4.20
1.00 93 . r_ .280
1.0
<10.
94.
tMoisE
Dilut.ion_Factor
Benzene
Ethylbenzene
Toluene
XyIene
Methyl-tert-butyleth
Naphthalene
Surrogate-spikel-
Surrogate-Spike2
Surrogate-Spike3
*H20 0
us/kg
us/kg
ug/kg
ug/kg
ug/kg
ug/kg
ug/kg
us/kg
ug/kgr
1.0
1.0
1.0
1.0
1.0
1.0
0.0r-0
0.010
0.010
6.6
01.
35.
r-.3
2.92
r..86
2.05
.920
4. 83
2.04
.410
.980
.140
74.
50.
<50.
<50.
<50.
<50.
<50.
<50.
36.
29.
28.
010 ;
0
0
0
0
0
0
0
0
I
0
0
2
6
0
0
0
0
0
0
0
5
4
:
05
01-
1
1
9
1
1
B
1
9
9
l-5.
5.9
6.8
Sample integrity
of Ehe NELAC
This Report may
Section l- of 5
Certificate of Results
certified prior to analysis. Test results meet aII reguirments
, except as noLed in Lhe QA Report Section 4.
parL, results relaLe only to items tested.
Jeff S. Flowers, Ph.D.
t/Technical DirectorPresi
Page 3 of 3
Jefferson L. Flowers, Ph.D
Jefferson S. Flowers, Ph.D,Al NEWBURYPORT Av.
ALTAMONTE SPRINGS
FLORIDA 32715-0597BUS: [phone]FAX: [phone]Serving Your Analytical and Environmental Needs Since 1957
1
Date Reported
Project NumberP0 Number
FLDOH Number
NYSDOH Number
CTDPH Number
rLouras
CHfA{ICAT.
T-ABODATOAtES
INCORPORATED
Received From:
Delta Env.-UT
1030 W. 5370 Southsalt Lake city,uT 84123
Jull-7 2001
AMSWUT-46
13 s0oEs
E83018
11595
0173
NCDEHNR Number : 296
SCDHEC Number : 960L9For: DRY WT BASIS BTEXMN8021 GRO
Date Sampled:,ful 2 200L Date Received:,Jul 3 2001 Lab Numbers: 4503-4513
REPORT OF INFORMATION
Parameter Unit Limit Expected Value Range Correlat.ion
GRO_Spike
*Moist
Surrogate_Spikel-
Surrogate-Spike2
Surrogate_Spike3
GRO_Spike
tMoist
Surrogate-Spikel
Surrogate-Spike2
Surrogate_Spike3
GRO_Spike
tMoist
Surrogate-Spikel
Surrogate-Spike2
Surrogate_Spike3
57.
63.
59.
46.
47.
46.
57.
63.
59.
47.
46.
46.
47.
46.
ug/kg
tH20
ug/kg
us/kg
ug/kg
ug/kg
tH20
ug/kg
ug/ks
us/kg
ug/kg
tH20
us/ks
us/kg
uq/kg
57.
63.
59.
47.
46.
4503
90.9
L0.2
35. s
29.2
28.4
4504
9l-.5
13 .8
35.7
29.4
28.L
4505
93 .1
9 .03
35.4
29.0
28.9
4 506
92.L
8.98
36.8
29.7
28 .4
;
1_
9
;
1
9
;
1
9
46.
:
0
l_
2
0
1
2
;
1
2
;
1
2
46
57 .9
63. r-
59 .9
The above information is inLended to highlight exceptional data as compared to the
upper control limits (f,imit) established for each of the parameE,ers. Range exceedances
are flagged by integer values in Ehe Range column. The Expected values are derived
from historical data. ExpecEed is computed as either the mean or computed directly
from another parameter using linear regression. A1I known correlaEion rule exceedances
are listed as enumerated rule numbers in the Correlation column. Correlation pair
rules are defined on the last page.
Jefferson L. Flowers, Ph.D
Jefferson S. Flowers, Ph.D
481 NEWBURYPORT Av.
ALTAMONTE SPRINGS
FLORTDA 32715 -0597
BUS: [phone]FAX: [phone]
sectiolSprfiFt'Your Analytical and ErR4trhftental Needs Since 1957
GRO-Spike ug/kg
EMoist tH2O
Surrogate-Spikel ug/kg
Surrogate-Spike2 uglkg
Surrogate_Spike3 ug/kg
,^
Received From:
Delta Env.-UT
1030 W. 5370 South
Salt Lake City,UT 841-23
Date Reported
Project NumberPO Number
FLDOH Number
NYSDOH Number
CTDPH Number
NCDEHNR Number : 296
SCDHEC Number : 96019
For: DRY WT BASIS BTE)(MN8021 GRO
Date Sampled:Ju1 2 200L Date Received:,lu1 3 2001 Lab Numbers: 4503-451-3
REPORT OF INFORMATION
CHfITTCAL
l-rtBOpArOUfS
TNCORPORATED
,1u11-7 2001
AMSWUT-46
1350085
883018
r-r-595
0r-73
Parameter Unit Limit Expected Value Range Correlation
GRO-SPike
SMoisE
Methyl-tert-butyleth
Surrogate-Spikel
Surrogate-Spike2
Surrogate-Spike3
GRO-SPike
SMoisE
Methyl-tert-butyleth
Surrogate-Spikel
Surrogate-Spike2
Surrogate-Spike3
GRO-Spike
SMoist
Surrogate-Spikel
Surrogate-Spike2
Surrogate-Spike3
us/kg
8H20
ug/kg
ug/kg
ug/kg
ug/kg
us/kg
tH20
us/kg
ug/kg
ug/kg
ug/kgr
ug/kg
%H20
us/kg
ug/kg
ug/kg
103 000
57 .9
63 .1
59.9
l_03 000
57 .9
63 .1
s9.9
2480
46.0
47 .L
46.2
2480
46.0
47.t
46.2
46.
47.
46.
4507
94.L
6.83
75 .4
36.2
29.5
28.3
4s08
93.7
10.5
64 .6
37 .5
29.0
28.3
4509
92.5
7 .62
36.8
29.4
28.4
57.
63.
59.
;
l-
9
;
l-
2
The above information is inLended to higrhligrht exceptional data as compared to the
upper control limits (Limit) established for each of the parameters. Range exceedances
uil ff"gged by integer values in the Range column. The Expected values are derived
from hii[orical data. Expected is computed as either the mean or computed directly
from another parameLer using linear regression. A1I known correlation rule exceedances
are listed as enumerated rule numbers in the correlaEion column. Correlation pair
rules are defined on Lhe last Page-
Section 2 of 5
Jefferson L. Flowers, Ph.D
Jefferson S. Flowers, Ph.D
481 NEWBUBYPOHT AV.
ALTAMONTE SPRINGS
FLORTDA 32715-0597BUS: [phone]FAX: [phone]
Serving Your Analytical and Environmental Needs Since 1957
r_Li wl_f
Page 2
/a
Received From:
Delta Env.-UT
1030 W. 5370 SouthSalt Lake City,UT 84L23
For: DRY lfl BASfS BTDO{N8021 GRO
Date sampled:Jul 2 200L Date Received:,Jul 3 2001 Lab Numbers:
REPORT OF INFORMATION
CHTilICAL
1ABODATOPIEI
INCORPORATED
Date ReporEed
Project NumberPO Number
FLDOH Number
NYSDOH Number
CTDPH Number
NCDEHNR Number
SCDHEC Number
: Jul17 2001: AIvISWUT-46
:13500E5
:883018: 11595: 0173: 296
:9601-9
4503 -451_3
Parameter unit Limit Expected value Range correlation
GRO_C6-C1O
GRO_Spike
EMoist
Surrogate_Spikel
Surrogate_Spike2
Surrogate_Spike3
GRO_Spike
SMoist
Surrogate_Spikel
Surrogate_Spike2
Surrogate_Spike3
GRO_Spike
EMoist
Surrogate_Spikel
Surrogate_Spike2
Surrograte_Spike3
GRO_Spike
SMoist
Surrogate_Spikel
Surrogate_Spike2
Surrogate_Spike3
57.
63.
59.
47.
46.
57.
63.
59.
47.
46.
ug/kg
ug/kg
*H20
ug/kg
us/kg
ug/kq
us/ks
*H20
ug/ks
ug/kg
us/kg
vg lkg
*H20
us/kg
ug/ks
uglkg
ug/kg
8H20
ug/ks
ug/kg
ug/kg
57.
63.
59.
57.
63.
59.
;
1
9
;
l_
9
;
1
9
46.
47.
46.
46.
47.
46.
45r_0
3790
9L .4
13.
37.
29.
29.
91.
13.
37.
28.
28.
;
L
2
;
1
2
;
1
2
45L
9
4
0
0
1
9
1
2
9
4
46
451.2
9L.2
1,4.L
36.7
29.9
28.5
4513
94.2
L4.6
36.5
29 .4
28 .6
;
1
9
;
l_
2
46
The above information is intended to highlight exceptional daLa as compared to theupper control limits (Limit) established for each of the parameters. Range exceedancesare flagged by integer values in the Range column. The Expected values aie derivedfrom hisEorical daLa. Expected is computed as eiLher the mean or computed direcElyfrom another parameter using linear regression. A11 known correlatioir rule exceedancesare listed as enumerated rule numbers in the Correlation column. Correlation pairrules are defined on the last page'
Jeffersonl.Frowers, ph.D
Jeflerson S. Flowerq Ph.D
481 NEWBURYPOBT Av.
ALTAMONTE SPHINGS
FLORTDA 32715 -0s97BUS: (407) 339.s984FAX: [phone]
secrionSgrvipqYour Analytical and EryjLogental Needs Since 19ST
FLOWERS CHEMICAL LABORATORIES
Ouatt ler Key
J Sunogelo rscovory Imlls have beon exc€€d€d;
No known qnllty controt critods exlst3 tor th€ @rpo.ahl;
Tho aanple mald( hleder€d wlth lhe abltty to nrako arry accutais d6lermlmllon.a senpb h6ld b€yond the acc€pted holdtng tme.
U lndlcalo! thal the codpound v/as erEvzed toa but hol d€locl6d.
1
0
,i
07{2-01 '
Analyzed
Co3l lndlcalos thsl lho anaM6 was dotected ln both the samDle and lhe assodeld molhod blank.
NormBB
Exed
425
slm
.
,t .
AMSI /UT-16
13500E5
Prolect Numb€r
PO Numb€r
Dal6 sampled
ATEXMNSO2l
RlI
-t-trr-
-
t il il I
EIFT I IllrlIIII
-
L!'.trLEtilI
ETIE:TIEEEIEIIEII
-
il.=I-=riln RilIE-EI'IEIBI
'ErIttrtIlEl-!,F, ItFnr Eillt!'rtEllltErI Ellt,Itr!!!I,EEII EillEilil-EtilttilIil EITTIEE rrrIrIrI IIIAEfiD ItrUI'IilTEEETEi-
-
drtrtr atltr atlrr ttlr ErlllEilrr ;iilrf,lllrEftEIlllttl Ellilt+Ji,r,ttil EtrlETEtirilriErirrrffi.!!-IiltilEllllilFEII ErIril ilErruEl ill:l:rrfitE iE:ErIElrl4ll|Itr-IT I-TII III rfi[II-Ilttt- I E!7taI narl mr:r EriEr EErII5EEIr.rnEillFr.r lEItEIrlil:!ilt ilIIEEi[ilrrnIilGr-il-il EEEEE EIE+T tJ:rltrt:rt[1IEEiEillFilEllf,lllhlI AltI EilI IEilI EIII f,1itl EilEII ll'rril[EZI rtrrftl-*r6Et I 6!EI E!!.!r E;tr f+.ttr t?irEllrFltrEilf?Ir f,liIF r Elun[Eil EilGIIIIl'll|'IIttD-EEIf,i[If,ilrrE'ilr f,iitlFlllE!ilrFilIf,lltl FliIFt!il l"-ri!tF-r[tErr El|l:IElEIilttATtrilTilItrAAIEEIIIElIa!il8[rtElIEtIEiil Eilra[Ht+:til[EErt EIIlErrrr'irEdlltlrFiln [ il llnr Eltr Erlrr tItEL|Ir*-?rrf,+ilr6-f,tlllftrl ll'ilrrl[IB rEilGTTIlIilMIFFIEIIIE]ilIflltl Erle+il-EifirEitr ErllIEtrElt-E rtFt[Itrrr Et TEftI'II?:IIffiffiIil[UilEIElIEIIII tilEilIe+rrEi[EIIf,il lrtMltl[Itil ITGflII'rlIrIIIIIFtrIIEIilEEEIEtiI.I EEtrIEIFTEIilEI'III ErzfEfE-ElrItFrilraf.rtr ITGfTliltl|'IIETIETjIEEI.IEEET ilEEf,-EEtrIFlt]I EEilFI*llrlrEt6ErrrE':n EEGTEEIEMilEMlIIIFiIIdIiltr*il Elf..IEt*rEriL-EEt ril EEIililTTII.E EEIllfIlill?.ll
-II-T rI-r II I-r II_
I
)
Section 3 of 5
,^
Qual ity Assu rance Report
Report date: L7 -Jul-01
Prepared for:
Project Number:
Lab Numbers:
Delta Env.-UT
AMSWUT-46
4503 - 4512
OHEITICAL
TABCPATOPIES
Section 4 of 5
TLOIryEAS CHIMICAL
TABOPATOPTES.INC.
QA
SDG Narrative
Summary
Client: Delta Env.-UT
Project Number: AMSWUT-46
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
LabNumbers: 4503-4512
Sample Handling
Sample handling and holding tim6 critsria wsre msl tor all samples.
Samples Collected by Submitter. No unusualevents occur€d during analysis.
Surrogate Compound Recoveries:
The recovery limits were exceeded for 6 samples as shown in section 1. Thls
represents a 85.0% success rate.
Surrogate exceedences are aftributed to matrix interferences.
Accuracy / Precision:
The recovery_llmits were exceeded lor 1 compound in the matrix spike as shown in
section 2. This represents a 87.5% success rate.
The recov.ery limits were met for all compounds in the matrix spike duplicate as
shown in section 2.
The RSD was met for all compounds as shown in section 2.
Method Blanks:
No larget compounds were found in the method blank in excess ol the method limit
as shown in section 3.
LCS Check Sample:
The control limits were exceeded lor 2 compounds as shown in section 4. This
represents a 75.0% success rate.
Section 4 of 5
Standards Traceability:
The t-test limits were met for all calibration standards as shown in section 5.
The t-test limits were exceeded for 2 Lcs standards as shown in section s. This
represents a 66.770 success rate.
The t-test limits were exceeded for 2 matrix spike standards as shown in section 5.This represents a 66.7% success rate.
The t-test limits were met for all surrogate spike standards as shown in section 5.
1
TLOTryEAS OHEATIOATIr\BOpAfOplES"INC.
QA Section 1
Surroqate
Compbund
Reccivery
Client: Delta Env.-UT
Project Number: AMSWUT-46
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
Lab Numbers: 4503 - 4512
GRO_Spike for EPA80158
Unit of measure: ug/kg
Surrogate Expected: 100
Acceptability Limits: SB.2 - 1gO
Laboratory
Number
ffi-r,...ii,,
4503
Site
SS1
Surrogate
Recovered
.'-W,#r,".ffi+ffi ::::j:::: jij,-ii::,:! ]
90.9
Percent
RecoveredH,ffi. ffi
90.9
4504 SS2 91.5 91.5
4505 SS3 93.1 93.1
4506 SS4 92.1 92.1
4507 SS5 94.1 94.1
4508 SS6 93.7 93.7
4509 SS7 92.5 92.5
451 0 ss8(4')91.4 91.4
4511 ss8(5')91.9 91.9
4512 SS9 91.2 91.2
Section 4 of 5
Description
TI_OWEPS OHE,}TICALrABOpAfOptES"INC.
QA Section 1
Surroqate
Comp6und
Reccivery
Client Delta Env.-UT
ProjectNumber: AMSWUT-4G
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
Lab Numbers: 4503 - 4512
Surrogate_Spikel for EPA8260
Unit of measure: ug/kg
Surrogate Expected: 30
Acceptability Limits: 22.4 - 36.4
Laboratory
Number
4503
Site
SS1
Surrogate
Recovered
35.5
Percent
Recovered
118
4504 SS2 35.7 119
4505 SS3 36.4 121
4s06 SS4 123
4507 SS5 36.2 121
4508 SS6 125
4509 SS7 123
4510 ss8(4')125
4511 ss8(5')124
4512 SS9 122
Section 4 of 5
$1i-Biif'Xifl6iil
ii,s.rff
ts-F ,
i$?,i#ii,.1iii.$
TLOWEPS OHEMIOAL
L\BOPATOPIES.INO.
QA Section 1
Surroqate
Comp6und
Reccivery
Client Delta Env.-UT
ProjectNumber: AMSWUT-4G
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
Lab Numbers: 4503 - 4512
Surrogate_Spike2 for EPA8260
Unit of measure: ug/kg
Surrogate Expected: 30
Acceptability Limits: 26.8 - 32/
Laboratory
4s03
Site
SS1
Surrogate
Recovered
'i.--8fi.fl.,lil.il
llitl.i_
29.2
Percent
Recovered
-.-t-j- ..,., .',,.4.11---
97.3
4504 SS2 29.4 98.0
450s SS3 29.0 96.7
4506 SS4 29.7 99.0
4507 SS5 29.5 98.3
4508 SS6 29.0 96.7
4509 SS7 29.4 98.0
4510 ss8(4')29.0 96.7
4511 ss8(5')28.9 96.3
4512 29.9 99.7
Section 4 of 5
SS9
TLOTryEPS CHEITIOAT
Ir\BOQATOAIES"INO.
QA Section 1
Surroqate
Compbund
Recovery
Client Delta Env.-UT
Project Number: AMSWUT-46
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
Lab Numbers: 4503 - 4512
Surrogate_SpikeS for EPA8260
Unit of measure: ugkg
Surrogate Expected: 30
Acceptability Limits: 25.3 - 33.2
Laboratory
Number
4503
Site
SS1
Surrogate
Recoveredffil ,ffiffi
28.4
Percent
Recovered
ffi"ffi,.,'g-ffi
94.7
4504 SS2 28.1 93.7
4505 SS3 28.9 96.3
4506 SS4 28.4 94.7
4507 SS5 28.3 94.3
4508 SS6 28.3 94.3
4s09 SS7 28.4 94.7
4510 ss8(4')29.0 96.7
451 1 ss8(5')28.4 94.7
4512 SS9 28.5 95.0
Section 4 of 5
Descriotion
:::i1_1.:.::1.r..1=i:Ii:a;.i..ir.rt:.]iifftiir:i:lli+j::::!:::::::1.+::::r.:]n::.:ljia
TLOWEQS CHIATICALlr\BOPAfOplfS"Ilt{C.
QA Section 2
Matrix
Soike
R'ecovery
Client:
Project Number:
P.O. Number:
Date Sampled:
Lab Numbers:
Delta Env.-UT
AMSWUT-46
13500E5
2.Jul-01
4503 - 4512
Analyte
GRO_C&C10
Unit
iiiii,,illii
::iii::i:ii::i::ii:tli
ug/kE
Analysis
Method
t{i?,,ti,1.+1+lifi..,1'l.ii{
EPA8O15I
Date
07-03-01
Spike
Added
lif,i,,ii+l.rl.,:,ii
iiiiiitiilif.,i.l,,.:,i
1000
Sample
Conc..ffi
<10
MS
Conc.
914
MS
Rec.
i
91.4%
MSD
Conc.
970
MSD
Rec.
97.0o/o
Acceptable
Limits
-
239 - 1441
STD
Rec.
39.6
Acceptable
Limits
i'iii+ijr#ii+i.iii;il#.i.--ri?i j'j
,iir,il.#+iiiii,{;-ri#
0-363
Benzene udke EPA8260 07-11-01 20.0 <1 21.5 108%20.6 1O3o/o 't4.8 -24.2 0.636 0 - 2.81
Ethylbenzene r talVr EPA826O 07-11-01 20.0 <1 20.4 1V20h 19.9 99.5%16.3 - 23.0 0.3s4 0 - 1.93
Toluene r ralVc EPA8260 07-1 1-01 20.0 <1 19.6 98.0%19.0 9s.0%14.6 -24.3 0.424 0 - 2.85
Xylene ttalkr EPA8260 07-11-0't 60.0 <1 61.0 102%60.2 1OfJo/"48.'t - 71.0 0.566 0 - 6.78
Methyl-tert-butylether ttakt EPA8260 07-11-01 20.0 <1 139%26.0 130%11.7 -26.5 1.27 0 - 4.09
Naphthalene UEK(EPA8260 07-11-01 20.0 <1 16.5 82.5%o 16.0 80.0%12.4 -27.4 0.354 0 - 4.48
lsopropylbenzene ug/k(EPA8260 07-1 1-01 20.0 <1 23.2 116%21.9 110o/o 14.7 -24.3 0.919 o -2.52
Section 4 of 5
a i:*::!
ii[7
1
TLOWEPS OHIATIOALIr\BOPAfOplfS"lNC.
QA Section 3
Method
Blank
Report
Client Delta Env.-UT
Project Number: AMSWUT-46
P.O. Number: 13500E5
Date Sampled: 2-Jul-01
Lab Numbers: 4503 - 4512
Analyte
GRO C6-C10
Unit
IJiiiiE:::::-
ug/kg
Method
EPA8O158
Date
07-03-01
Concentration
<10
Benzene uglkg EPA826O 07-1 t-01 <1
Ethylbenzene ug/ks EPA826O 07-1 1-0 1 <1
Toluene ug/kq EPA826O 07-1 1.01 <1
Xylene ug/kg EPA826O 07-1 1-01 <1
Methyl-tert-butylether ug/kg EPA826O 07-1 1-01 <1
Nephthalene uglkq EPA826O 07-11-0'l <1
lsopropylbenzene ug/kg EPA826O 07-1 1-01 <1
Section 4 of 5
TIOWET]S CHEITIOALlABOpArOpIES"INO.
QA Section 4
LCS
Recovery
Client: Delta Env.-UT
Project Number: AMSWUT-46
P.O. Number: 13500E5
Date Sampled: 2-Jul-O1
Lab Numbers: 4503 - 4512
Analyte
GRO_C6-C10
Unit
ugkg
Method
EPABOl58
Date
07{3-01
LCS
Exoected#
::: j:i::t':::l+rE:+li::llrEnu
:.:r.:.:ii:.:.:.r,:,:.:,:.:r:.i:.ir+::r:an:
200
LCS
Measured
,'.1W,.,.-
174
Rec.
o/to
iii::ii*.i.,,:t.;*:P;i_:sF_;:I'i:t+:!:+iii:!Irii4:!:tir
87.O%
Acceptable
Limits
ffiii,-ffi....iffi
97.1 - 2U
Benzene udks EPAB26O 07-1 1-01 10.0 12.2 122%7.15 - 12.8
Ethylbenzene udkg EPAB26O 07-1 t-01 11 .6 116%7.40 - 12.7
Toluene udks EPA826O 07-1 1-01 10.0 11.4 114To 7.16- 12.9
Xylene udks EPA826O 07-l 1-01 30.0 35.3 11 8%21.5 - 39.1
Methyl-tert-butylether udkg EPA826O 07-t t-0r 10.0 180%5.75 - 13.9
Naphthalene udks EPA826O 07-l 1-01 10.0 7.97 79.7Yo 3.78 - 14.7
lsopropylbenzene udkg EPA826O 07-'t1-01 10.0 139%6.66 - 13.8
Section 4 of 5
10.0
rH# BrU
TLCTryEPS CHEATICALL\BOPATOPIES.INC.
QA Section 5
Standards
Traceability
Client:
Project Number:
P.O. Number:
Date Sampled:
Lab Numbers:
Delta Env.-UT
AMSWUT.46
13500E5
2-Jul-01
4503 - 4512
Compound Manlacturer
Name
Manfacturer
Lot #
%
Rec Date Valid
UntilLot
Prep Date Valid
Lot
t-test t-test
ranoe
.iililiiiii'Iii.
Sonto
Mean
0ontro
srd
Lot
Mean
.
Lot
stdffi
Benzene
LCS
Matrix Snike
Ultra
Ulra
R0540
R0540
1397 :harle 1Gl2-00 08-30-02
1397 :harle lGl2-00 08-30-02
2345 harle 06-19-01 02-21-02 4.29
4.29
>1.68
>l_58
o.976
o.976
0.052 1.08
l.o8
0.080
0.080Ethylbenzene
LCS
Matrix Spike
Ultra
Ultra
R0540
R0540
1397 :harle lG.l2-00 08-3G02
1397 :harle 1G,12-00 08-30-02
2345 :hule 06-19-01 02-21-02 6.33
6.33
>1.68
>1.68
0.975
o-97.s
0.M7
0.047
1.06
1.06
0.053
o_0-53
Ultra
Ultra
R0540
R0540
1397'.harle lGl2-00 08-3G02
1397 :harle lGl2-00 08-30-02
2345 :harle 06-19-01 02-2142
2345 :harle 06-19-0l O2-21-o2
5.46
5.46
>1.68
>1.68
0.986
0.986
0.067
0.067
1.05
1-Os
0.056
0.055
UItra
Ultra
Mt06z
Ml062
1395 :harle 10-12-00 04-30-02
1395 :harle 1Gl2-00 04-30-02
2345 :hwle 06-19-01 02-21-02 ilrl'Esji 12.M
!2.O4
0.951
o.9_51
0.066
0.066
1.26
1.26
o.255
o.2ssNaDhthalene
LCS
Matrix Snike
Ultra
Ultra
R0540
R05,10
1397 ;harle lGl2-00 08-30-02
1X97 ;harle lGl2-00 08-30-02
2345 thule 06-19-01 02-2t-02 12.00
+2.0{)
0.681
0-68 r
0.091
0.091
0.885
0.885
0.10s
Isopropylbenzene
LCS
Matrix Spike
Ultra
Ultra
R05/+0
R0540
1397 :harle lGl2-00 08-3G02
1397 :harle lG.l2-00 08-30-02
2345 :hwle 06-19-01 02-21-02
2345 :harle 06-19-01 02-21-02
1.88
1.88
>1.68
>1.68
t.02
t.02
0.045
0.Ms
1.17
1.1't
0.135
0.135
)
Section 4 of 5
ffi
Ioluene
LCS
Metrir Snike
Methyl-tert-butylether
LCS
Metrir Snike
i $#:
n 1n(
)
CHAIN OF CUSTODY RECORI)Page I of I
)
U7
Release #
l/,"C,
\,/'--
c *q6
ts
tsilling and Report lnformation:
W.O # (Project #)
Projed Contact
Project Name
Address
[)cltu Environrtte ntal Consultants. lnc.
10.10 Wcst 5370 South
Salt Lake City, Utah 84123
(rJOl) 261-'8(x)6 FAX [phone]tJ
3 6lt t,,<ot {zc:o soath
Sampler Signaturc-{)Colleclion Date(s)
laboratory Name
Numbcr of
C-onuiners
Prescrvativic
Tpe
24"_
Analpis Required t -Sample
TypcDatc/fimeField ID Number l^WSampling Number
Tpft funrcrns,il I6ltot 3:sbFl-4't5oJss-l Ltt' )
I I t I{,'),1-ot ?:octffo(ss-A Lb')
Io{6-kotJ:arf5S-3 ( t?',)
I6dt" t d:/sPQLS,t-L/ ( tq')
?r-o I ttroAg-7s5-( L1')
o.Q 7l-ol &:ht+I
74-o t t'{o/4o1SS-) ('{ ')
I
Ilo1-t -ct I tr"'JoASs-( ( '/' I
t/1-J-c: t ?:?SAJS-r xw6')
I
I1-J-0 I F:.SA,l tz-Ss-q ( y')J J {-7lo t f'JY44stsSJ-zo ( v, )
Company Date/fimeReccived by (signature)C-ompany Date/TimeRelinquished by (signature)
\r/L Fnn 1)-ot /l'loh
llslot ort\
24 Hours
tE Hours
5 Daf,s
10 Days
As Contracted
Other
Thrn Around Tlme:
Y. -U
Comments:
)
I
Ulrt fr-.t
PM: Jetfery Rsine
Project:AMSWUT-46
Rec'd b SJW
4503 - 4513
Flowers Chemical Laboratories, lnc.
Cooler Beceipt, Custody Record Vedfication, preservation Fom
Yes No NA
a.
b.
c.
d.
e.
I
s.
h.
i.
i.
k.
t.
m
n.
o.
p.
q.
Airbills or airbill slicksrs
Traffic reports or pacldng lists
Custody soals on shipping containers
Custody ssals intact?
Custody soal numbors
il yss,
Allblll or airbill slickerShippedvia: Airbill#:
Cooler Temperature upon receipt <4 Degrees C
lI sampls vials recsived, were bubbles observed?
ClienUFCL chain-ol-custody forms present
Was condition ol shipping containers OK
Sampls tags pressnt
Were sample containers in good condition
Wers all contalners labeled conecty
Did all labels agree with Chain of Custody r€cord
Were conect contain6r€ sent br r€quested analysis
Wers samples propsdy preservsd (s€e below)
Proisct Managsr notifisd as to discrepancies
Explanation of DiscrepancieyRemarks
E
Returned Containers
Preservation Chsck
nt
P.250mL
P.500mL
P.1L
P.2L
Wir-Pac
40 ml. vials
G.250mL
G.500mL
G.1L
G.4L
Tedlar
x 11
x
x
x
x
Yes
IIIII
x
x
x
III
rIIIIIrII x
IIIIIIII
>12 NaOH
<2 HN03
H2SO4<2
<2 HCL
Na2S2O3
rIIII
Cliant pela EnY.-lrT FCL Lab #:
Cooler Rec'd onozoi/or os:so Cooler opened on: 07.03-ot
Log-in dats: o7.oo.ot
E
E
E
E
I-x
E
frlxtr
LL
Lxlx
E
UNDERGROUND STORAGE TANK PR OCRAM
Adjustment Tracking Form
l*,(BP rq.,-,o,
+{c
FAC # rioO rS
FACILITY NAME:
OWNER NAME:
fi s loo o(a)e{i ku-s
(circle one)
REASON FOR:
/0'tn'LOar oss
Adjustment @)d 84<-3o.:
Jlnraa Us{6lz I z.jr0i
Oil*o tr 4rwrrt ttstorf
Drt /:a F o
\zzo
Jt 6+yt
\+,J ?-r
RE-BILL?Yes o
BY:DATE:
APPROVED BY:
+ -7 f o3lot
iilr6.Tits/w"ir.
I
i9 s?
Ftfi 07194
WHITE - timrc
CANARY - Selbr/Aoorcy
PINX - Buyer/4offiy
Voucher Dqte
Budget FY
Vendor Code
Address
STATE OT TIIAH. DIVISION OF FINANCE\- vruoon PAYMENT voucHER Verldd Poyrrent Wdldel
Mdc Eorhordl I l/94
9-Jul-01 Accounting Period O1 lO2
FM/FYMM/DD/YY
Vendor Nome BP AMOCO OIt COMPANY
Tronsoction l.D.
P r 480
Type Agency Document Number
Agency Control Number
KRIS BEYER
28IOO TORCH PARKWAY - STE 3OO
DOCUMENT TOTAL
$67s.00
WARRENVILLE IL
City Stote zlp
Description (25 Chorocters)
TANKS REMOVED
Vendor Une
Number
Fund Agency org Approp.
unlt
Acttvlty Expend.
Obiect
Revenue
Source
Projecl
or Job
Reporting
Coteoorv
Bolonce
Sheet
Accounl
Amount
4001 576 l 100 480 4731 NAC 4:!95 4no(
4001 576 t00 480 a37l NAC 23t 0 4no(
TOTAL
'fi,"4
Quolity - DERR
Agercy Hsd d Au0uiad A8eil ApProval OriSimting Agercy/Division
\-
-r#"*""*.,
lA.-.
Rinsate disPosed at
Tanks cleaned YN BY:
lnerting LEL or % OxYgen obtained:
Non-exPlosive atmosPhere inside tank obtained bY:
-
Purgin
)roduct lines were:
-
Cleaned, secured in place , and caPPed Removed, disPosal site:
Soil disPosalsite:
'ank disPosal site:
lD or FID meter readings (indicate location on the site Plat.)
*e- 5
Gain or Calibration sPecs
eter TYPe:n: 0-3 feet Greater than 3 feet
:il contamination is evident: Y orJ of
Depth to water table:7 t3 ' slope di rection of surface toPograPhY:
ater contam ination is evident: Y
Certified Lab:
mber of samPles collected GW Soil: USC
alysis Methods
N lndicate location and dePth of samPles on the site Plat
3ector observed collect'to n of samPles:
:ector collected duplicate samPles them to the State Lab tor analYsis
taminated soil was
St/
D,,t
'.L5
I
State UT
OtherCommercial
Phone
2kl2(
CapacitY (gallons)
dP
States
Contact
L
Location Name
Address
c
Land use of surrounding area:
Owner Name
Address l./
ulf zi
-Car^tog!&
LfiPCJ;
5t ,l
ype (Steel , FRP, ComPosite)
ubstance Stored
last used
t.^^ I \+c,l ,^
rllt /p-t-5,
t
\
9t
/
ADsl-uL t e.sloiL /zs!-a-Closed
2
How closed (Rmvd, in Place, CIS)
= # ol tanks remaining+ New tanks- Closed tanksOriginal# of tanks
\2i t I oCert. #: GS 12
& SoilSamPler: J
Expiration Date:
Cert. #:TR
ST Remover:
t o/ t olExpirationDate
N
N Copy ot closure Plan is on Site
rator has an closure plan
I tc{By
Disposed at, *O\
Produ ct removed: Y N
Disposed at:YN BYSludgeremoved
HOC Other:O&G TRPH
Jtion:lnsPector.
and submitted
lf yes, confirmation samPles were collected: Y N
-lcsurepl rev0201 .wpd
Lflc(] 6
Tank No,Tank No.
)t
of
6"
UTAH UST PROGRAM
Permanent Closure
c" p"ite
Cleaning and Bemoval:
iite Assessment:
YN
t}Js
o
o
t(
+
7<X)
islands.lndicate samples qolEcted by the sampler the
PEro-rFlD
--*
Ut (e.laz,h
Ssley
S'lrcr€.6-*.95
Y ,e^-ls -(r--6.- +
\f.'
\L
stB I I\Is \
tr oaCtlrvl
I
tf
P
6*$q *>€ t s#E1
_@)99i
\
(r*"
9{"rrr.^"
drroJrn
g dq_-E?a %r,*
dr"/\"
(c
U
\S:a sS 6q*sS
tarr.rkWc.Pa\r(r
Show of all
Also ol
Active Water WellProperty Line )4 r qaVCommercial Buildings \n' 52Residences z5O ' .ro,kL
-fiaturatGas Line go, {*,--,-Water Line ^:+5 ,Sewer Line - J;?)'Surface Water
Other:
y€.
Storm Drain * 75ElectricalLine t U4"ha/^i,Telephone tine " 1b t
commenrs: gE 4 Ll @ t), Ov h L5 Bpv
*. >H
d3 A t2t b*v^,1 nrd
I I
l*1 6 lZt l'2q,
lo
certify that I the above-named on (date)o/b,28
Lrz€ /at i62Cefi#(Date:lnspector's Signature:
bution: White-DERR, Yellow-lnspector,Closurep2 rev0201
Permanent Closure Facility lD:! Oo /5"-7(
Faeility Site Plat
I
l---.---tII
p,
-!Tt=>ffi
I
Utah
Method used on flex connectors (B , CS, NC, CP , NM, NP, N/A)
Enclosed containment sumps at tanks (subPumP ,) and disPensers
lndicate dates ol uPgrades-lining,tank or PiPing
Testing
are
and 3
cathodic Protection'
6
Pi
trle,JrA
t* bo$- Date
F\ex lestet
ale
r att tl15
Owner Name A DR* lLl^ha 6. \Location
Qtoo Tcrr.ln ?*Y-ua.,,,r, Sta3ofAddress L
,t,lNP- state ]L
k":= Be,^-0,- pnone d3O f<.{^-Ai/J
zrp L0S5
Contact
City t
Location Contact 521
State UT
Phone
Complete for each tank.has more
Tank 4TqfrDNumber of tanks at facility:
I[\ /(qTank lnstallation Date
\2 k-t2l<r). kCapacity of tank (in gallons)
(/'n L tJn r 1:L..lsSubstance stored vv.{Tank is in use (Y) or, it not in use, give date last used
,/lf not in use, depth of product in tank (in inches)
Note anY
le
sump,
noIt
It
can
column.
U
Yes
all
Yes No
25thanlessoltransfers
translers of less than 25 n0 overlill
the
Current year tank tags are in Place
FRP etc.)composite,olon tanks (steelconstructiofMaterial
etc )FRP flex plastic,of pipi (steelngolalconstructionMateri
etc.)suction,safe/US gravitY(pressuretypePiping
NP)SA,tc,cs,lL,tankson (NM,usedMethod
SA,rc NP)cs,(NM,on pipingusedMethod
theAnswerProtection.Conosion
€ gr"L
ves / t'to^rS
lilled
if lilled
markeddarm iq
seen
voltsSubSub
voltsSub
voltsvollsSub volls
Disp.
volls Oisp.
volts 0isp.vottsDrsp.
Yes No
\r\hu\0n:
olOwner or Owne(s
Page of
ID
Cathodic Protection
lor each tank'
stem:
Ownership of Tanks
lorm.
Lt t?"-,'
Answer iollowing for all tanks.Note any exceptions IN the last column.
tank6.excePtions in
tollowing lor
,.\
Methodusedlortanks:,SS'R \,^.J."fAea^ POe.c.}S, Methodusedforpipinq:
Manutacturer, name and model number of system:\ I corl c r (2r' ir T l-S - ISTJ system s'o party cert. avaitabtei(D ruo
Y bv tank ar lv exceD ons to the anYes
@*"Ail Records on site document that the system is properly installed, calibrated, and
maintained (system and tank setup reports, maintenance records).
@ruo(-rb tvt Device documentation is available on-site (owner's manual, etc.).
@*oAIEquipment used to acquire data, take readings, perform test is adequate, accessible and
functional. lncl. ATG console, dipstick, etc.
(e) NoDocumentation of valid testing or monitoring is available tor the last 12 months. Show
testino or monitorino results in qrid below.
All
zf"tl ruovATGThe probe is located at the center of the tank. lf not, the tilt correction factor for each
tank is shown on the tank setup repqlt.
G*oATGThe tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test and the tank size is within the allowed
upper and lower size limits.4Secondary barrier is properly placed and constructed, designed for gw considerations,
has an acceptable permeation rate, is compatible with the substance stored, is non-
corrodible, and is not in the 25-yr floodplain (per s!!9 39999!rn9!!tr-
IM
@*"IC MTG
.dtr)
readings lor product inputs and withdrawals are properly obtained and
recorded. Beadings are ProPerlY
lnventory
No@Records include the proper number of water readings, and water readings are used to
adiust inventory balances as necessary'-@
'@ No
^-T6
MTG An appropriate tank calibration chart is used and is available for review
VF9 noDispensers have current calibration stickers or proper calibration documentation.rc 6h\
ot
Nobottom.tc
ornofor
t
Ll-#t
Moffr
and extend to within one foot of the
tank for the last 12
tubes are
results of mon
P PPPpP?P P?t-rP#L t3pPt9PP?pPtL?<t?#3
f,**i Tank 4
'6F9
#
LeakLineTesting,Line TightnessandTank
Test results:
test tor tanks:ol
Name and certiticatiol numbe r ol tester:
test forol last
results:T
Test Method:
Q'ss fi6,st-l^,(,Fs.
NoYes
Name and certification number ol tester:
Date ol last leak thanless pressure,atmosPhericatthatoperatesshowpipingtoveriliableandavailableISDocumentationpiping:Sudion olSalehasvalve
+Comments S loo (e-
?'-
.wpd
Utah UST Program
Tank and Piping Leak Detection ID
P\J?PP?PP7-a
Detector Testing:
Statelf {-Itah
DEPARTMENT OF ENVIRONMENTAL QUALMY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
Michael O. kavitt
Govcmor
Dianne R. Nielson, Ph.D.
Exccutive Director
Kent P. Gray
Diretor
168 North 1950 West
P.O. Box 1,148,10
Salt Lake City, Utah 841l4-4840
(80r) 536-4100
[phone] Fax
(801) 5364414 T.D.D.
www.deq.state.ut.us Web
TILE COPT
ERRU-130-01
June 20, 2001
Carl Magnus
BP Amoco Oil Company
dba Rainbo Oil
474West 900 North
Salt Lake City, Utah 84103
RE closure Plan Approval for Underground storage Tanks (usrs)
Located at Rainbo #46,3612 west 4700 South, west valley city, utah
Facility Identification No. 400157 6
Dear Mr. Magnus:
The Closure Plan for the above-referenced facility, received by the Division of
Environmental Response and Remediation (DERR) on June l4,2OOl,has beenapproved subject to
the noted modifications, if any. The DERR office and the local fire department must be notified 72
hours before beginning closure activities. L,ocal agencies may have additional requirements for
closure or may charge inspection fees. The Salt Lake Vatley Health Departmerrt i, ,ro longer
performing closure inspections. Please be sure the DERR office (not Salt Lake Valley Heatttr
Department) is contacted at least 72 hours before the closure takes place.
The Closure Plan Approval is effective for a period of one year from the date of approval.
ff closure does not take place within one year, submittal of a new Closure Plan will be required,
unless otherwise approved by the Executive Secretary ruST).
Any change to the approved Closure Plan must be submitted, in writing, and approved by the
Executive Secretary (UST) before implementation. If contamination is suspicted oiiounO during
closure activities, you must report it to the DERR at (801 ) 536-41 00 within 24 hours of discovery.
Enclosed is a copy of the Closure Notice form, which must be completed and submitted to
the Executive Secretary ruST) after the closure is performed. Please submii the environmental and
Unified Soil Classification sample analysis data and Chain of Custody forms with the Closure Notice
as soon as possible, but no later than 90 days after tank closure.
Kent P. Gray, Executive Secretary (UST)
Utah Solid and Hazardous Waste Control Board
If during upcoming closure activities, it appears that a confirmed petroleum release has
occurred, then the conditions, as explained in the attached notice, may apply to your site provided
all the applicable rules and regulations are complied with.
If you have any questions, please contact paul Harding at (g0l) 536_410g.
Sincerely,
DJ..,- , *--/,F
Facility ID# 4001576
Page 2
KPG/PRII/hsp
Enclosure
cc Ted Itchon, West Valley City Fire Department
Bennett Ireper, Delta Environmental Consultants
UNDERGROUND STORAGE TANK CLOSURE PLAN (rev. 10/04/99)
LH
ewer
LHD Approved
mailed to State
FAcrLrrY D# 1CiiS76
E L
Received i -t4'et
Mailed to LHD
te Received From LHD
ieweriDate o
Review/Date
Closure Plan prepared at the request of the owner/operator (identified below)6e uueTt( zeftp
A Contractor may prepare this Closure Plan as the owner/operator's agent. ln preparing the Closure Plan, the Contractor
must act with the owner/operator's knowledge and approval. The owner/operator must sign the Closure Plan.
This Closure Plan is submitted in compliance with the requirements contained in 40 CFR 280 Subpart G and R311-204
(u.A.c.)
Tank Owner a Phone * tBo t I fa. /- I et ?
[ ]soleproprietorship [ ]partnership [ ]corporation
eaaress Lt}-Y Ctt, Q0a.Lto c Stt state ()f zip 8* ta z,
Facility Name '?.a- rr R D at+ A
Address "36t2 r"L.. "{)oo S n.4,{City
Contact person (-,/ zt
Total number of regulated underground tanks at this site 3
Total number of regulated underground tanks at this site to be closed
TANKS TO BE CLOSED
-3 ;i,."ili:"iVIt]
U zip 8?
Phone #tfia nf&/-???
. lndicate the specilic substance slored in each lank to be closed (regular, unleaded, diesel, waste oil, etc.)
For waste oil tanks: Have degreasing or other types of solvents been stored or mixed with the waste oil?
Yes (identify i{ known) ,y /l No
--
Not known
Analysis for lead or other contaminants may be required prior to disposal of contaminated soil or other material
your disposal facility.)
Tank #
Type (Steel,FRP,etc.)
t;Z 3 ,'i:{ )
sfecc sktc SlEEL
Date lnstalled claq 6 /ar G/tq
Capacity ( Zooo.r*lzooo e4 i2ooo *e€
Substance stored
!yrLr.4ra.o
6,tl*li,n.
UN.eilt.,0
6tr-slrn.
UNCe40eO
Gr+Sat,^rt
Date last operated r/t/, r rht/or sAt/or
Removed/ln Place/
Chanqe in Service?
kxe
lZ.e t'acut0
'fu DE
Ek.ltttt ll)
fo I7E
ECtntyEt)
(Check with
)ate
or (company nanq b?-cil Exv taoxrt tzt.,f#C brus tr L/4.vh Phone + t9ott?>o-qro?
Address / 03oQ ' S32o So. ciry S(a srate u/ zip??rz3
4 vurt r-o
,1
TANK REMOVER
L
SOII-/GROUNDWATER SAIUPLER Name
CONTACT LOCAL EALTH DISTRICT Name of
CONTACT LOCAL FIRE DEPT. Name of Dept.
DISPOSAL INFORMATION
Contact Tifle_
Cert. # TR Od Pop a;n"ley'.f/ot_
Phone #8wo
Cert #
Phone #
Sute (z # zip 8q/>3
is located must beor
Phone # (
S
€.
)
ourr--QlZb.L-
Title /nsP,ee.foft phone# rtat la..= -?}rn
Tank(s) will be disposed at:tl*5 €L
Contact .L
Product lines will either be: K removed or _cleaned, secured in place, and capped.
Vent lines will either be: X removed dr cleaned and secured open.
Piping will be disposed ar: Facility
S Lr'
Contact person
Taak(s) will be emptied by:
Tank(s) will be cteaned by:;3 4rt tzc OGt Ef
Contaminated water in the tank/rinsate rrill be disposed at:
Contact
Tank(s) will be:__trurged or X rendered inert by the following
Residual sludges will be disposed at the following facility B{
5cc state-l; 4 _ zip_?1_LoJ_
State U zip I vto ?
Contact
5
ltU A 0_
Phone # Gql=t?73 -97€)
Phoner ,#*j' ,8?Rs,>G
Phone*t8ot l8*8-.rVa6
Phone #rfur t#-s>a4
crty&rfuarrt"-state-_12 j-_zip_L$_qf-o{
lJ,+,Qts Phone# t9at lSZg-S;laa
[ ] Facility site Plat, Sample Information Table, sample results and chain of custody fornrs are included.
[ ] Approval for in-place closure has been granted by the Local Fire Department.
Fire Phone#
[ ] Approval for in-place closure has bcen granted by the Local Health Departnrenr
Health District_phone#
[ ] Substance to be used ro fill tanks
ate
Contact Date
2
crry 5Z C
GS E*p.
r4ot t;zla-* AAddr""t crry_S_CC___
Before the closure is submitted for thc local health andcontacted.Grand,W'asatclL
Adfu""t
All materials generated from UST closures must be managed and disposed in a manner that does not place those materials
in direct contact with the environment. On-site stockpiling of contaminated soils may be required prior to any soil
management activities. Anypersonproutdng remedra/asststance fora fee, nc/udngaeration andover-excavation (oimore
than 50 yd), must be a Certified UST Consu/tant.
Contaminated soils generated as part of tank removal are to be disposed at the following facility:
F-f *r. ilr)n/IF\Address (reSe C<l- r 3 City
Stare L/f Zip €4lct? Contact pe t)Phone * t€o t)773 -RaAr*
S]TE A SMENT
A site assessment must be performed for all UST closures, and change-in-service. Site assessments must beperformed as outlined in 40 CFR 280.72 and R311-205 (U.A.C.). lf contamination is suspected. additionat samptes
must be collected at the location where contamination is most !ikely to be present. lf oroundwaterjs e-ncountered.
a soil samDle must be collected. in the unsaturated zone. in addition to each qroundwater sample. Soil andgroundwater samples must be analyzed for the compounds shown in the following table, usingmppropriate labmethods.
Substance or
Product Type
Contaminant Compounds to be Analyzed ANALYTICAL
METHODS
Soil, Groundwater
or Surface Water
Gasoline Total Petroleum Hydrocarbons (IPH); and Benzene, Toluene,
Ethyl benzene, Xylenes, Naphthalene, (BTEXN) and MTBE
EPA 80158 I and EPA
80218 'or 82608
Diesel Total Petroleum Hydrocarbons (TPH); and Benzene, Toluene,
Ethyl benzene, Xylenes, and Naphthalene (BTEXN)
EPA 80158 and EPA
80218 or 82608
Used Oil Oil and Grease (O&G) or Total Recoverable petroleum
Hydrocarbons (TRPH); and for Benzene, Toluene, Ethyl-
benzene, Xylenes, Naphthalene (BTEXI.| & MTBE; and
Halogenated Volatile Compounds (VOC's)
EPA 1664 or 55202
and EPA 8021B or
82608
New Oil Oil and Grease (O&G) or Total Recoverable petroleum
Hydrocarbons (TRPH)
EPA 1664 or 5520
Other or
Unknoryn
Total Petroleum Hydrocarbons (TPH); and Benzene, Toluene,
Ethyl benzene, Xylenes, and Naphthalene (BTEXN); and
Halo Volatile S
EPA 80158 and EPA
8021B or 82608
I The following modifications to these certified methods are considered acceptable by the Executive Secretary (UST):
A Dual colunrn confirmation may not be required for TpH & B TEXNA4TBE analysis.
B A micro-extraction or scale-down technique may be used for aqueous samples.
C Hexane may bc used as an extraction solvent.
NOTE: 'fhe sarnple preparation method and any modification(s) to a certified method rnusr be reported by the laboratory on the
final analytical report.
2 Methods or test procedures allowed for Oil and Grease (O&G) or Total Recoverable Pel.roleum Hydrocarbons (TRPH) are 5520(b) or 5520(0
respectivcly.
Complete the Facility Site Plat and Sample lnformation Tabte on pages 4 and S to provide site assessment
information.
CONTAMIN ATION INFORMATION
lf contamination at the facility is suspected or confirmed, the information must be reported to the Executive Secretary (UST)
at (801 ) 536-4100 within 24 hours. The Division of Water Quality must be notified at (801 ) 538-6146 if Free Product is
encountered or if surface water has been impacted. lf contamination is confirmed, any person assisting in the remediation
process for a fee must be a Certified UST Consultant.
J
CONTAM.INATED MATERIALS IilT ee olsposeo Rr aN nccepraeue . ^crlrry:
F in tanks,
p. I and
The site Plat must
and other relevant
5 of the Closure Plan'
Facility D#Lt 9otl?6 Drau'nBv
tr5t
Scale. t" -
-FeetfI
North
Site Plat Must Indicate:
/ Current & former tanks' piping & dispctrsers
Z iocution of all samples to be taken ..-
, ililil.' fences, & p'op""'' o::']1.'::','],'
rir,, ,rs.
/ Utility conduits (se\Ncrs' $?S' trattt ' '
electrical' etc )
1 = Sxrnple locations (SS+' WS-#' USC-#)
* = Vtoni,oting Wells fMW-#')
O = Soil boring (Sefl,';r Geoprobe Bonng (GP-#)
i = ivu,., wels (domestic' livestock' "t:- ) ^.',
Srow or surrace t"*ril;i';'o':;*' *tl). s' sE' E' NE)
t,and Use At Site:- n*ii"'iti"r Commercial - lndustrial
Surrounding l'and:- n*iJ",,tr"' .- com^rercial - lndustrial
4
information'Tank and
scale.It
Date
I
R esidentiol
CAR WASH
trosh
s
AMOCO STATION' #+a
I nir ao*n londscope oreo I r,itt oorrn
c
---w--
---G--
londscope londscope
E
er
--G------
vent
I
N
I
prPes
+6f',I sp-:
NG WELL /sewer /
cleonout
SP-,1o ??o
ss-{ St-Q
\
E
\ r,lc't
sP-2o
o ? r?t x0-
cle
PUMP ISLANDS
-tO
c Srnt o 9-)GI
sS-8
SP-5
o
sP-1o
stormu orotn L-------------J
sP-6o
o (/)
oG)Ji|,X,
OC'
r
lo\dscope
E
ross
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vocon
f ield
RAINBO STATTON #463612 WEST 47OO SOUTH
WEST VALLEY CITY, UTAH
FIGURE 1
SITE MAP
Project No.
I 3500E5
Prepo.cd by
LF,/Sl-.B
o.qro by
JUA
2/ 1/s8
Oot.
5ro
Raicrcd by fllcnom€
I 3500s &,^Delta
Envi(onmoolal
consultants, lnc.
Empty Lot
oJ
o_
Etrj
d power ne
47OO SOUTH
CON 0
01020J0
Scole (feet)
LEGEND
o
o
----w----
----E----
----G----
MONITORING WELL LOCATION
SOIL PROEE LOCAIION
I,YATER LINE (BURIED)
ELECTRICAL LINE (BURIED)
ELECTRICAL LINE (oVERHEAD)
CABLE TELEVISION
GAS LINE (EURIED)
I
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JUN-12-20s1t 15:59
2
3
1
Bt IOCO HSE DEPT
SAM PLE INTg.RMATION TABLE
Complete taHe for all sampbs to be takan for closure.
801 521 4965 P.g2/t2
D. hlcen al G2 toer beloqrlfie bEclfit/mEvr Eoil hbrfrc6.
F e).
Approximata depth to gmund'irater ln the vicinity ol the tanks: 2- O leet
Regimal groundwarerfloldirection: ll^e* H
State Cortified Lsbotatoryto bs w
,41--ja ut sltau Pl*zw_B,Zlt
Contac{ person pnone* r?l} r 339 -sifir
Please orplain any unusual or extenuating drarmsaoces erpected reganling the site assessment or dosure
Semple #Substance
sloled In
tanlr
Samplc
Vp*t
Depth2 Compoundsl Analysis method(sf
s5-l (i*ol-,oz *rl Ie lrl zkatiifl
s5-z (/'I 7
ss-)\I
sS -?L
s5-r I e9 I
ss-Q I
/
s5 ->
,s-g
I
s5 *?I
9g -/o I I t f
usc #t r ,glq'tSt -L/sZ# z li /L ,Lq (JIS,C
I certtfy underFcnatty of law ttret I am the owner/oporztor ol the tank(s) reforenced above and ttrar I am tamlllar withthe inlormation on this form and that lt and complete, and funher, that the procaduros descriDeclhcreln wltt be lollowed durlng
Signalure of tank owner
Full Name of tank owner
a
TNTfl P 14?
c
ls true, aocurate
Date
GJsc)"
l
Bozt6 f go6rE
/
I
a
Closure Plan Review Summary
Facility !D 4001576
Number of regulated tanks at this site not previously closed: Database:
Certificate of Compliance lssued: Yes
TANKS TO BE CLOSED
Non-Notifier:
3 Closure Plan
NO
0
Tank# Type Date lnstalled Capacity Substance Last Used Rmvd/ln Place
I Composite (Steel w/ FRP)llllll989 12000 Gasoline
2 Composite (Steel w/ FRP)llllll989 12000 Casoline
3 Composite (Steel w/ FRP)11llll989 12000 Gasoline
5 3l
5 3l
531
RMVD
RMVD
RMVD
TANK REMOVER
Name
SOIUG ROUNDWATER SAMPLER
Name: C BENNETT LEEPER Cert. #:
1
GS-104s Exp. Date : 11l1Sl2OO2
State: Zip:
State: Zip
AARON SPACKMAN Cert. #: TR-39 Exp. Date:
lf different from database:
Tank Owner:
Address:
Site Name:
Address:
Remarks:
COPY TO PAT]L ORGINAL TO FILE
Phone:
City:
Phone:
City:
Thursday, June 14,2001 Page 1 of 1
Closure Plan Review Summary
Facility lD 4001s76
Number of regulated tanks at this site not previously closed
Certificate of Compliance Issued: yes
TANKS TO BE CLOSED
Non-Notifier:
Database: 3 Closure Plan:
NO
0
Tank# Type Date lnstalled Capacity Substance Last Used Rmvd/ln place
I Composite (Steel W FRP)llllll989 12000 Gasoline
2 Composite (Steel w/ FRP)l1llll989 12000 Gasoline
3 Composite (Steel il FRP)lllll1989 12000 Gasoline
5 3l
5 31
5 3l
RMVD
RMVD
RMVD
TANK REMOVER
Name:AARON SPACKMAN Cert. #: TR-39 Exp Date: 10/15/2001
SOIUGROUNDWATER SAMPLER
Name: C BEI{NETT LEEPER
lf different from database:
Tank Owner:
Address:
Site Name:
Address:
Remarks:
COPY TO PAUL ORGINAL TO FILE
Cert. #: GS-1045 Exp. Date: 1111512002
Phone:
City:
Phone:
City:
State: Zip:
State: Zip:
Thursday, June 14, 2001 Page L of I
UND
LHD USE NL
Date Received_
evtewer
ate LHD Approved_
ate mailed to State
ERGROUND STORAGE TANK C SURE PLAN (rev. 10/04/ss) FActLrTr tD*__1_a_Qls_26
ATE E
Bece o
te Mailed to LHD
ate Approved_
. Review/Date
EeClosure Plan prepared at the request oI the owner/operator (identified below)UNFJf(ZEqZP
ot (company nam e'1 lZ-C+4 Exv ttzoxt,nzt,l*C dattsr-,L/4,<rh phone * (goil?.ir.tt-?ro&
Address l OloQ s37o So City Sz-t state ,Lt_zip89rZS
A Contractor may prepare this Closure Plan as the owner/operator's agent. ln preparing the Closure plan, the Contractor
must act with the owner/operatofs knowledge and approval. The owner/operator must sign the Closure plan.
This Closure Plan is submitted in compliance with the requirements contained in 40 CFR 280 Subpart G and R311-204
(u.A.c.)
FACILITY INFOBMATION
Tank Owner BP 4rnar a
[ ]sole proprietorship I lpartnership [ ] corporationq>9 LlJ. Qoo I t..,c Stt sl lg utzip 8+to3Address
Facility
Address
Name 4 G
Contact person L tll4L
'36tL e-u. 4 TooSool,f City U zip Bq
Phone * (8a r t32 /-?q'29L4
Total number ot regulated underground tanks at this sile 3
Total number of regulated underground tanks at this site to be closed
TANKS TO BE CLOSED
' lndicate lhe specilic substance slored in each tank to be closed (regular, unleaded, diesel, waste oil, etc.)
For waste oil tanks: Have
3
Yes (identify if known)
stored or mixed with the waste oil?
No Not known
degreasing or other types o, solvents been
,V /l
I
Tank #.li z 3
Type (Steel,FRP,elc.)s/tec sltcc s*eec onm€ntal Rgsgome &Remedialion
Date lnstalled G/as 6lac G/aq
Capacity (Zou.ro lzooo e&lZOo O *e?
Substance stored'
!^Lt"(ra.O
*,rgtl'r.uN.ei&4
6*:g1,..
UN(E'fiEO
Gr+Sttt ^*
Date last operated s-brhr qlt/ot slt/or
Removed/ln Place/
Change in Service?
lote
l?t*eutO
,b EE It
e*scl)P.euwEO
Received From LHD _
Phone#(Bot \re /-9?/1.
RECEIVED
Analysis for lead or other conlaminants may be required priorto disposalof conlaminated soilor other material. (Checkwith
your disposal facility.)
Envl
z
S OIUGROIINDWATER SAMPLER
Cert. # rR oA3? exp. aate!e/r.r/ot_
rA 8woPhone #7lr
Cfun# cs /Dq
Phone # t*o t \ 2)a-7to
Stt sat"l<._f_ ziptLllZL
CONTACT LOCAL XIEALTE DISTRICT Name of
Oonfont
CONTACT LOCAL FIRE DEPT. Name of
DISPOSAL INT'ORMATION
is located must be
Title_Phone #
oeot. t <tes* U*&ty &ly Gec Drd. ox"fu/ot_
Titte /xs PEcfb ft phone * tfla t tqAS -?YG
S#etTenk(s) will be disposed at:4
5Li state-lZt- zip_O_fu o_t _
Contact L
Product tines will either be: K removed
Yent lines will either be: X removed or
or cleaned,securedinplace,andcapped"
and secured open.
Piping will be disposed at:
o
Contact person A.+r t Lla qt t-
State U zip__g_YteL
Phone #
Phone#,
Phone #
WB / ltrec *lCJTank(s) will be emptied by:
Tank(s) will be cleaned by:
Contaminated water in the tank/rinsate will be disposed at:
Contact
Tank(s)
I t 8o t tBzS-t'Va6
Phone *tfut tH-S>a6
will be:---tlurged or -L rendered inert by the
Residual sludges will be disposed at the following B 4rt t FT
eaa'o' PO Ep( 7i3S-O ' ciq._*rfuJa&.stzte__rzt__zip_93@tr-or$
Contact Wrson 0M A LIC H *uS 6 ,o phone # (ga I \ g?gt,-5;)a6
FOR CLOSIIRD IN-PLACE ONLY
[ | Facility Site Plat, Sample Information Tablg sample results and Chain of Custody fomrs are included.
[ | Approval for in-place closure has been granted by the Incal Fire Department.
Fire Dept. Phonef__Contact pnls
[ ] Approval for in-place closure has been granted by the Local Health Department.
Health District Phone#
I I Substance to be used to fill tanks
2
TANKREMOvER Na^e 4Uo,.< S p*CLuqay
x*o, .DIo (D . (4Lt Fo f.*n* ciry_5z-E--
lradl;"u ( O3 o Ltt. 53 )a Sa.
the local health
()
Wasatch,
Addrot 38o Se. Op-*l,rz-Z aifv
Fonilitv
A dz{raoc tQo Lt,1,-E
CoNTAMINATED MATERTALS MUs-]r orsposeo nr an a ^-try,
All materials generated from UST closures must be managed and disposed in a mannerthat does not place those materials
in direct contact with the environment. On-site stockpiling of contaminated soils may be requiied prior to any soil
manageme-nt activities. Anyperson prourdrng remedial assbtance for a fee, including aeration and over-excauatbn (oimore
than 50 yd), must be a Certifrbd L/ST Consultant
Contaminated soils generated as part of tank removal are to be disposed at the following facility:
F-f ]rr Ht)n/ET
State-.!2t zip-Q-91O1-Contact person 7EJ phone * @o t l?p3 -Ad6r
S]TE ASSESSMENT
A site assessment must be performed for att UST closures and change-in-service. Site assessments must be
performed as outlined in 40 CFR 280.72 and R311-205 (U.A.C.). lf contamination is suspected. additional samptes
must be collected at the location where contamination is most likelv to be present. lf oroundwater is encountered.
a soil sample must be collected. in the unsaturated zone. in addition to each groundwater samole. Soil and
groundwater samples must be analyzed for the compounds shown in the foltowing tabte, using appropriate tab
methods.
Substance or
Product Type
Contaminant Compounds to be Analyzed ANALYTICAL
METHODS
Soil, Groundwater
or Surface \[ater
Gasoline Total Petroleum Hydrocarbons (TPH); 4qg! Benzene, Toluene,
Ethyl benzene, Xylenes, Naphthalene, (BTEXN) and MTBE
EPA 80158 I and EPA
80218 I or 82608
Diesel Total Petroleum Hydrocarbons (TPII); and Benzene, Toluene,
Ethyl benzene, Xylenes, and Naphthalene (BTEXN)
EPA 80158 and EPA
80218 or 82608
Used Oil Oil and Grease (O&G) or Total Recoverable Petroleum
Hydrocarbons (TRPH); and for Benzene, Toluene, Ethyl-
benzene, Xylenes, Naphthalene (BTEXI.Q & MTBE;and
Volatile Organic Compounds (VOC's)
EPA 1664 or 55202
and EPA 80218 or
82608
New Oil Oil and Grease (O&G) or Total Recoverable Petroleum
Hydrocarbons (TRPH)
EPA 1664 or 5520
Other or
Unknown
Total Petroleum Hydrocarbons (TPH); and Benzene, Toluene,
Ethyl benzene, Xylenes, and Naphthalene (BTEXN); and
Volatile s
EPA 80158 and EPA
80218 or 82608
I The following
A.
modifications to these certified methods are considered acceptable by the Executive Secretary QST):
Dual column confirmation may not be required for TPH & BTEXNA,ITBE analysis.B. A micro-extraction or scale-down technique may be used for aqueous samples.C. Hexane may be used as an extraction solvent.
NOTE: The sample preparation method and any modification(s) to a certified method must be reported by the laboratory on the
final analytical report.
2 Methods or test procedures allowed for Oil and Grease (O&G) or Total Recoverable Petroleum Hydrocarbons (TRPII) are 5520(b) or 5520(f)
respectively.
Complete the Facility Site Plat and Sample lnformation Table on pages 4 and 5 to provide site assessment
information.
CONTAMINATION INFORMATION
lf contamination at the facility is suspected or confirmed, the information must be reported to the Executive Secretary (UST)
at [phone] within 24 hours. The Division of Water Quality must be notified at [phone] if Free product is
encountered or if surface water has been impacted. lf contamination is confirmed, any person assisting in the remediation
process for a fee must be a Certified UST Consultant.
3
Aadress (oeSo (t)- t30/ S, city Ste -
1
I'ACILITY SITE PLAT (CLOSI]RE PLAN}
The site plat must be drawn to an appropriate identffied scalo. It must show planned sampling locations, zubstances stored in tanks,and other relevant information. Tank and sample identification numbers must be consistent with the information given on p. I and5 of the Closure Plan.
Facirity w*9,OblS2h--or^*r.sy 1eA 4#4ZdZb Ft(- Dare_
fI
Scale: l" = _Feet
North
X = Sample locations (SS+, !VS+, USC+)I = Monitoring Wells MW#,)
O : Soil boring (SB+), or Geoprobe Boring (GP+)
o = Water wells (domestic, livestock, etc.)
Slope of Surface Topography: OI, NW, W, SW, S, SE, E, NE)
Land Use At Site:_ Residential _ Commercial _ Industrial
Surrounding Land:_ Residential _ Commercial _ Industrial
Site PIat Must Indicate:
r' Current & former tanks, piping & dispensers
'/ Location of all samples to be taken/ Buildings, fences, & property boundaries/ Utility conduits (sewers, gas, water. storm drains.
electrical, etc.)
4
1
a a
Residentiol
\
-G
gross
trosh AMOCO STATION' #+a
CAR WASH
Ic
c
f nitt ao*n londscope oreo I r,ttt ao*n
--G--
--w--
Empty Lot
oJ
o-
Etd
londscope
c
londscope
--G------
*
,rf;-,
| ,p-,o
/\,a sewer / Et cleonout \
WELL
ss'{ tt-(.otsP-4 \\o
oe
(r
PUMP ISLANDS
\
E\'-tO I
#>lStnt o $-)\\\sS-8
sP-5
o
SP-1o
stormLJ- fl1616 sP-6o
o (')
oC4JS,[,
OC3)
t
\dscope
E
\
lo
L
as
oo(o
t'-)
RATNBO STATION #463612 WEST 4700 SOUTH
WEST VALLEY CIry, UTAH
FIGURE 1
SITE MAP
Proict llo.
t 350085
Prepored by
v/sto
ororn by
J}1A
2/ 1/s8
Dotc Raicrcd by
Sro
LEGEND
POwer
CO
oro2030
-E==-tScole (fcet)
47OO SOUTH
o
o
----w----
----E----
-E_----G----
MONITORING WELL LOCANON
SOIL PROEE LOCATION
WATER LINE (BURIEo)
ELECTRICAL LINE (BURIED)
ELECTRTCAL LINE (OVERHEAD)
CAALE TELEVISION
GAs LINE (EURIED)filcnore
I 5500S Ph^Delta
Envkonmental
con3uftants, lnc.
I
I
I
I
G
I
I
I
I
I
I
I
I
Ic
I
I
I
I
I
I
I
I
I
N
I
I
I
J|]/^].-72-2o@L 15r59 BP AI,IOCO HSE DEPT 881 521 4965 P.O2/A2
Da lEhm al 0-2 het Ddgu$6 bNCdt/nr*va roi hbdrc6.
SAIIjPl-E INFORMATION TABLE
Complela laHe hr all sanples to be uken br doeure.
,
2
1 E s).
Approxinrate depth to goundrlra"ter lo the vidfitty ot fl6 ranks 2 O t*-
StaE Cedied l€borEEry to b€w
t+<oo.ksf,*te_il-zpB,zte
Contacl per€on nwg#fii\33.9-seei
Please arphin airy unr.Eual or extefiuating drulfislSoce! c(pedcd rcgnling the ale assessment or doEurs
Sample f,8ampl6
typet
Gompound8tDepth"Analr€i3 hethod(rf
s5-l (>aolroz 9tl eft I 3tuilrif[
s5-z (
ss ->\I
s5 -?L
s5-r @a* t
ss-Q I
/
s5 ->
5t-8
ss -?I
I I t,f
usc car eh'tSt
Usz#z r.l L---Lqt _psc
II
II
I
rr rI IrrrrITTIII
II
IIa-
ITIIIIIT
I csrtty naor Fcn!]ty of Lw lhrt I am tle curnerroFfitor of lhc tan{s) refarenced abovr and ltlal I am tamllhr ritr
tlre inlormation on rhis lorm and fhat lt b lruer accuralc and comp,etg and funher, lhat tho procodulls dcson'Dod
hlrBln $dU bc lollowed d
Sign ure of tank ouner
Full Nane ol tanl( otw*r
urhg
Date
IOTAL P ,O2
Regional groundrrater llor direcfion: y'/a e* H
Sqbgiance
siorEd In
i.nx
EoztR l6orrr
l
99 -to
Tffi 676
Owner_ggpe
tSvArn^oez {M
To-{" P^.K,,rs^ lf! @Address
';Wga3i
Area Code Phone Number
Contact Person At UST Location Phone #
2-8r00
t't'\^io*,rrr..
vllAe,
Certificate Year:
S
Code
VCou
Facility Name R^;t.
Street Address3LI2 U LlhC)
Certificate ol Compliance on site?260
6-rk\,Tank Tank 4
Current year tag is displayed Q9F) No No )mo Yes No
Tank presently in use d\ No No Noabq Yes No
lf not in use, date last used /
lf not in use, depth of product in tank (in inches)
Month and year tank installed \\l<q I qq
Capacity of tank (in gallons)rlK \2 t<.\ztl
Substance stored t\r (A^\ PtoLS (lt^l Pre-.r\
Material of construction of tank (steel, FRP, etc.)B,Lo"^ttosM lar-o-r,l).
Material of construction of piping (steel, FRP, etc.)Fr) D rop
Piping type (pressure, suction, gravity, etc.)O.cri Ctsas((,?s(
lV. Release Detection For Tanks lndicate the method(s) used r
Method used (enter method used and complete appropriale form).\l B S}R sr12
Emergency Generator tank (leak detection delerred)
Method used (complete separate form where applicable)+(.<_tt?sfR
Automatic Line Leak Detector type and model t-\oJxa^2 __i)
Date of last Leak Detector performance test f^.to([-/ .^-SPHl^a q'q ^t
Test result (pass/lail)fo.ts 3,0 t, (t-?[na\,
-
{l =Date of last Line Tightness Test I
Test result (pass/fail)
Name and company of certified tester UT
No leak detection required (must answer "yes" to all questions below)
Operates at less than atmospheric pressure Yes
^i"Slope of piping allows ALL product to drain into tank when suction is released Yes 7i.to
Has only ONE check valve, located directly under pump ves / No
Above information is verifiable; use comments section below to document how it is verifiable NoYe/
certify that I have inspected the above-named facility on
(monlh, clay, year, tim€)
Comments
(print
Signature of Owner or Owner's Representative Present During I
lnspectols Signatu
Dislribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner LDchecklist.wpd 2/99
UTAH UST PROGRAM
Release Detection
Facitity m xo. ltop |'TJ6
1
I,a n,Checklist
l. Ownership of Tank(s)ll. Location of Tank(s)
Number of tanks at facility:
V. Release Detection For Piping lndicate method(s) used and complete appropriate tank checklists where applicable.
,t
I
SIR as a method ot leak detection refers only to monthly monitoring using SlR. An annual test perlormed using SIR is considered a tank tightness test and
should be reported on the tank testino and inventory control form.
Name and address of SIR vendor:\Jos-,p <N\
in k No No No
&sog,
lnventory records for product inputs, withdrawals, and the amount still remaining
Records include the correct number of monthly water monitorinq readings.lfdlr No NofGI feT)uo Yes No
Tank inventory is measured and recorded before and after each fuel delivery a%! No 6;.,No GN"Yes No
Appropriate calibration chart is used for converting product level measurement to
oallons and is available for review.@*"No No Yes No
Dispenser pump has a current calibration slicker or appropriate cali
documentation.
brationql6d 9*"@*"@*"Yes No
The drop tube in the fill pipe extends to within one foot of the tank bottom ("t> r.ro 6G) r.ro (7")No Yes No
Ce\ ruo Yes No
Yes(Ndr Yes No
Yes (fr-d\Yes No
SIR monitoring records are available for the past 12 months. lf no, indicate which
Are any months results reported as "inconclusive"? lf yes, specify which months
in the comments section below.
Documentation of performance claims for the SIR method is available and shows the ability to detect leaks of 0.2 gph
Yes @
Yes
n @
No
No Yes {$>
Yes (E)
with a 95% or certificationof detection and or less of false alarm
months are mi in section below.
Are any months results reported as "fail"? lf yes, specify
comments section below.
/va\No
3rd party certiiication indicates the method has been approved for both tanks and lines.
\,_z
<V-e!>No
The volume of product in the tank is measu -Nred using a:Gauge stick
lf a gauge stick is used, it is long enough to reach the bottom of the tank.Yes,z
V
No
!l qgauge stick is used, the bottom of the gauge stick is:n"."rdu"Worn/
{""N{
.:..j .:
lnspector's Signature tt /z-I I cto
of Owner or Owner's Present Duri
I t_
Date
1 Complete to appropriate sections of the ATG checklist.
comments: ust a
Distribution : White-DER R, Yellow-lnspector, Pink-Facility/Owner LDsir.wpd 5/98
UTAH UST PROGRAM Facitity tD No.
Monthlv Statistical lnvdntorv BeconCiliation, {$lR} .
t )t
'f Nls +{
Please circle.Ye$ or No for'each iank
/irT}r refi[]]Tank 4
Yes No
'l
(iiN tto
r;a\
lf a gauge stick is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an inch over
the full ranqe of the tank's internal heiqht.
Overfi Chec
tank. Use if 4 tanks.
SPI LUOVERFILL PREVENTION
lark)f,ank2'lTankl Tank 4
ls the UST system is filled by transfers of 25 gallons or less? lf yes, spill
and overfill prevention is not required."J;'-9 /NA\\:=/Yes Yer I Yes No
ls there a spill containment device t@-uril|prevent release of product into
the environment? lndicate type: S({l_buckef} gal., Spill bucket >5 gal.,
Containment sump at tank fill. '.._-__------/
No@ 9*o No@ Yes No
Ball float (in vent line),
(specity)
ls there an overfill
(in fill pipe), Alarm, or Olher
on the tank? lndicate type q No NoCJ"9 Yes No
For overfill alarm only: ls the alarm located where it can be easily seen
and heard by the delivery driver?Yes r No,"/Yes /*o Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when lhe alarm sounds?
Tank 2 Tank 4
Yes No No
1
Yes No
RROSION
Tank Tank Tanklndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrificial Anode
(SA), or Not protected (NP).hdl Pipingtr2p PipingFap Piping
CP.3ASub-Pump Sub-Pump<tP-sA Sub-Pumo
<-c- s+Sub-Pumplndicate the type of corrosion protection on Flex connectors andior Swing
loints: Booted (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metallic (NM) and Not
Protected (NP)
Oispens6rC-P-S A Disrenser
C,P.\A
Disnser.P_ SA Dispenser
I II I
Tank lining
Tank cathodic protection
Piping cathodic protection (t I
CATHODIC PROTECTION TESTS Record results of the most recenl cath(
The results of the last two cathodic protection tests are available. (within
6 months of installation and every 3 years thereafter).No@ @No No@ Yes No
{-v-, Date A lz.lq 7
t
Tank. Tester Pq, rs vollr-....ffi volts
Piping. Tester Date
-
volts volts volts volts
Sub-PumpSub-Pump
R gf vors/volts ---) vors
Sub-Pump Sub-Pump
volts
Disp€nseron ?lvclqT
4
(
Flex.^ Disp6n$r
(q S\ vorni-votrs
--QEee{$r
--/volls
Dispenser
volts
lt (z l- l&r
Present During I
Yes No Yes No Yes No Yes No
For impressed current system: The results of the last three equipment
checks are available.60 days.)check red
Signature oi Owner or Owner's
lnspector's Signature:.
Distribulion: White-DERR, Yellow-lnspector, Pink-Facility/Owner Ldspillover.wpd 2ygg
1
UTAH UST PROGRAM
No
/r""
No
Tank 3
Tank
/
lf tank or piping has been
upgraded, indicate date
upgrades were performed:
Record the lowest reading for each tanUpipinqlftex set.
--?"
No. Llod/5+6
rclqq
t.
UTAH UST PROGRAM
Release Detection ln
Tank(s)t!.of
Facility lD
Checklist
4qb
sut 47o0 S
Zip Code
Contact Person At UST Location Phone #
lor each tank. lf
Facility
Sa*
JCountu - A<^ [+ L^h
Add
City
Street Address\Lt)
Tank 4
5ll
has more than 4 tanks, complete information for additional tanks on
Number ot tanks at facility:
Tank
City State Zio Code
vJoEt \1,^tl, rzj.i.- , ( -' 44Ua
Area Codeqd\Phone Number- Lt4 r 9
certiticatiof compti@
Current year tag is displayed NodB dD No @No Yes No
Tank presently in use No@ @No @.) No Yes No
lf not in use, date last used /
lf not in use, depth ol product in tank (in inches)
Month and year tank installed $ lqq rlqat rr /eq
Capacity of tank (in gallons)i2-l{t2k 1z11
Substance stored R."6-" Ll.\i.',\ .'d Lh t Pr""^^ Ll^ [I
Material ol construction ol tank (steel, FRP, etc.)G*x";4.(*i,lz f^*,D;U c.ste<,t wt L'Kl
Material ol construction of piping (steel, FRP, etc.)Ft2 rc FRP trpp
Piping type (pressure, suction, gravity, etc.)8..-a..R -<c S--. ..
lV. Release Detection For Tanks lndicate the method(s) used for each tank. Complete the appropriate checktist lor each method used.
Emergency Generator tank (leak detection deferred)
appropriate tank checklists where applicable.
Method used (enter method used and complete appropriate form)
Method used (complete separate form where applicable)
Detection For Piping lndicate method(s) used and
Automatic Line Leak Detector type and model L-l--
Date of last Leak Detector performance test d 1-t ^ 4l 1- \) -cl+1->0 -17
Test result (pasVlail)0r <<oas E o/a, S C
Date ol last Line Tightness Test
^
-t- L0 - 17 1-Lo 41 1-Ui -q1
Test result (pass/fail)lo4 ((/U<c n4 SC.
Name and company of certified tester ?-9 Cert. No. UT lZ(
No leak detection required (must answer'yes'to all questions below)
Operates at less than atmospheric pressure Yes No
Slope of piping allows ALL product to drain into tank when suction is released Yes No
Has only ONE check valve, located directly under pump Yes No
Above inlormation is verifiable; use comments section below to document how it is verifiable Yes No
3lq lq 4certify that I have inspected the above-named facility on
(lMth, d6y, yoe, tim)
I
(
(pdil
\
Signature of Owner or Owne/s Bepresenlative Present During
lnspector's Signatu
)
Distribution: White-DEfi R, Yellow-lnspector,Revised 2/4/99
t d
"Ali{,}?To ,\c-n*",m,^ ^ DBA P^;\^,",
G"r)0eryr CrE,
(ro <-tr>1T rz
lfn SAR 1TR
Manufacturer, name and model number ol
Please circle Yes or No for each question lor has more
C'h\@ 6;;\Tank 4
Device documentation is available on-site (e.9., owner's manual).ves (G)Yes fNa Yes rD Yes No
Records on site document that the system was properly inslalled and calibrated (system
and tank setup report).
Yes -N;\v Yes @ Yes @ Yes No
System is maintained in accordance with manufacturer's instructions(records are
available on site).
No@ No@ @no Yes No
The probe is located at the center of the tank. lf no, indicate tilt correction factor lrom
the tank setup report.
No<F
Tilt:
No@
Titt:
No@
Titt:
Yes No
Titt:
Device can measure the heiqht of the product to the nearest 1/8 of an inch €es-) ruo G, No rG> Po Yes No
Device monitors the in-tank liquid levels over the lull ranqe of the tank's internal heiqht -f@ No <6D No .YeG) No Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the
device is equipped with roll ol paper ror results documentation)
No@ No@ NorY6>Yes No
Documentation is available demonstrating that the Automatic Tank Gauge performed a r
valid leak test at least once a month for the last 12 months * *ves @ Yes .T[F\Yes fT\\+/Yes No
lf no, for which months was a valid test not performed? (specify months and year, use
space below if necessary)
The tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test
Yes No Yes No Yes No Yes No
The tank capacity is within the upper and lower size limits required by the
manufacturer's equipment protocol to ensure a valid leak test
Yes No Yes No Yes No Yes No
Have any of the leak test reports indicated a failed test? lf yes, specify in the space
below the month, year, and what follow-up actions have been taken.
Yes No Yes No Yes No Yes No
Documentation of performance claims for the automatic leak test leature is available and
shows the ability to detect leaks of 0.2 gph with 95% or greater probability of detection
lndicate month(s) of invalid or missing test
Yes No Yes No Yes No Yes No
and 5% or less of false alarm
lndicate month(s) of any failed test:
Com
t)
, t/4 /qq
W.r- sfl€-
Signature of Owner or Owner's Representative Present During
lnspector's Sig
Distribution : White-DERR, Yellow-lnspector, Pink-Facility/Owner Bevised '12\95
UTAH UST PROGRAM Facirity rD
Automatic Tank Gauging
Please complete all for each necessary il theUse additional has more
SPILL/OVERFILL PREVENTION
knk)ft!!2)L6nP Tank 4
The UST system is filled by transfers of 25 gallons or less. l{ yes, spill
and overfill prevention is not required.Yes @ Yes @ Yes @ Yes No
ls there a spill containment device that will prevent release of product inlo
the environment? lndicate type: Spill bucket <5 gal., Spill bucket >5 gal.,
Containment sump at tank fill.
9No,kd'5 +r,{
No q, No
t x4A
Yes No
ls there an oved
Ball float (in venl
(specify)
ention device installed on the tank? lndicate type
;;, Automatic shutoff (in fill pipe), Alarm, or Olher
(ssJ tto
As Qruo
A5
@no
AS
Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
Yes No Yes No No No
No No No No
and heard the d Yes
Yes
driver?
For overfill alarm only: ls the alarm located where it can be easily seen
Tank 1 Tank 2 Tank 3 Tank 4
Tankas Tank(4 Tank
CS
Tanklndicate the type ol corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrificial Anode
(SA), or Not protected (NP).PipingFRp FI2 P
Piping Piping
+PP Piping
caSub-Pump
CP
Sub-Pump Sub-Pump Sub-Pumplndicate the type of corrosion protection on Flex connectors and/or Swing
joints: Booled (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metallic (NM) and Not
Protected (NP)
DisFnserc0 OP
Dispens6r c-oDisp€nsgr Dasp€nser
lf tank or piping has been
upgraded, indicate date upgrades
were performed:
Tank lining
Tank cathodic protection
Piping cathodic protection
CATHODIC PROTECTION TESTS Record results of the most recent cathc lowesl ding for each tank/pi1 ilex set.
The results oi the last two cathodic proteclion tests are available. (within
6 months of installation and every 3 years thereafter).Yes No Yes No Yes No Yes No
DateTank. Tester volts volts volts volts
Piping. Tester volls volts volts volts
Sub-Puhp
pa5S votts
Sub-Pump
pat 5 gdts P4 {gvotts
Sub-Pump Sub'Pump
volts4
1-Lt- q+Dateh4"*e-rr^Flex. Tester_Fh g; ,on"
Dispenset
lO or 5 Svolts
Dispenser
}ara.$orts
Dispenser Dspensor
volts
-a?
(
tCo
Yes No Yes No Yes No Yes Nocheckired
For impressed current system: The results o{ the last three equipment
operation checks are available.60
lnspectofs Signature
of Owner or Owner's
Distribution : White-DERR, Yellow-lnspector,Flevised Z4l99
\
UTAH UST PROGRAM
and Corrosion Protection
Facility lD
Checklist
vesf
Y{",/""
Date
SIR as a method of leak detection refers only to monthly monitoring using SlR.
tightness test and should be reported on the tank testing and inventory control
An annual test performed using SIR is considered a tank
Name and address of SIB vendor:
tr r2r o
@- ruo (G Ho @,No Yes No
lnventory records tor product lnputs, withdrawals, and the amount still
remaining in the tank are available lor each operating day.
Records include correct # of monthly water monitoring readings..@Ho @No /-iE! ruo Yes No
Tank inventory is measured and recorded before and after each fuel
delivery.
q@ H"@N",/velr No'>-/Yes No
Appropriate calibration chart is used for converting product level
measurement to gallons and is available for review.@*o No@ @to Yes No
Dispenser pump has a curent calibration sticker or appropriate calibration
documentation.
,G) no
g tq9 e No
tq9
rTb ruoYtq r Yes No
The drop tube in the lill pipe extends to within one foot of tank bottom.@*o @uo NoCra,Yes No
SIR monitoring records are available for the past 12 months. lf no,
which months are missing in the comments section below,
indicate
*ves @ veql@ Yes @ Yes No
Are any months results reported as "fail"? lf yes, specify which months in
comments section below.
Yes @ G"l
No
/qq
ves.Gi\Yes No
Are any months results reported as "inconclusive"? lf yes, specify which
months in comments section below.
Documentation ol performance claims for the SIR method
0.2 gph with a 95o/o or greater probability of detection and
certification).
No
is available and shows the ability to detect
a 5o/o or less probability of false alarm (3rd
leaks of
party
@ruoz @uoffi
fT*\t
No3rd party certificataon indicates the method has been approved for both tanks and tines.G
The volume ol product in the tank is measured using a:Gauge stick .G'
ll a gauge stick is used, it is long enough to reach the bottom of the tank.Y/s */
lf a gauge stick is used, the bottom of the gauge stick is e"$.u,ot
lf a gauge stick is used, it ie marked legibly and the product level can be determined to the nearest 1/g of an
inch over the full range of the tank's internal height .
z(q (Q
Yes No
<r
\
Comments 4 arL D-e--,4g Mrxk o@tu-
I Complete to appropriate sections of the ATG checklist.
Signature of Owner or Owner's Representative Present During
lnspector's
Distrlbution: WhitlDERR, Yellow-lnspector, Pink-Facility/Owner
|
"""
Not__.
iili.i,',...,,,.,, i 1,,
..
No
,n/,"
\'
.\J
{o o /r76
BPAmoco
re@
BP-Amoco
Mid'Gontinent Business Unit
28100 Torch Parkway, Suite 300
Warrenville, lL 60555-3938
__-{Q30) 836-6000
jCERR'' lilillEllTJL RESp0llSE & RErriil,; r,,'r ' ,;
,
March 10, 1999 iNTERTD
.F'rJ
Utah Department of
Environmental Responso &
168 North 190 West lstFloor
Salt Lake City, UT SalI " , . -.,
To Whom It May Concern:
Please be advised that Amoco Corporation has merged with British Petroleum.
All license renewals and new business license applications will now be processed through
our new location.
Once you have received a check and the application, please forward the actual license
to the following address:
BP-Amoco
Mid-Continent Business Unit
Suite 300lKris Beyer
28100 Torch Parkway
Warrenville, IL 60555-3938
Attached is a list of sites currently located in your area that you should have records for.
If you have any questions, please contact me at [phone]. Thank you for your
cooperation.
Sincerely
Kuz &ap,
Market Analyst
Attachment
KB:ck
r_-
Utah Department of Environmental Quality
Amoco
28100 Torch Parkway Warrenville, lL 60555-3938 Kris Beyer/Suite 300
City State Zip Code Phone #Facility Manager NameMarket Name RBU#Site Address
Salt Lake City UT 84109 8014847002 Patrick T. GreenSLC North 7102 3041 E 3300 South
SLC North 71 03 877 S. 1300 East Salt Lake City UT 84102 801-583-4429 Colline Hansen
SLC South 71 05 4770 South Highland Salt Lake UT 84117 801-277-8781 Thomas Bertanian
SLC North 71 08 3301 S 2300 East Salt Lake City UT 841 09 8014877981 Patrick T. Green
SLC South 71 09 1344 East Ft Union Salt Lake City UT 84121 801 -943-531 I Grant Olsen
Salt Lake City UT 84123 8012663684 Neysa XanthosSLC West 7113 4111 S Redwood Road
SLC South 7 114 897 East 6600 South Salt Lake UT 84107 801 -261 -1 289 Fred Ramezani
SLC South 7117 10615 South 700 East Sandy UT 84070 801-267-4724 Kim Komar
Salt Lake City UT 84102 8013282671 Scott MattinsonSLC North 7118 680 E 400 South
SLC North 7120 176 S 1300 East Salt Lake City UT 84102 8013220087 MichaelWilding
7123 1699 W North Temple Salt Lake City UT 841 16 8015967784 Bradley AldousSLC North
West Jordan UT 84088 801 -267-981 I Robert BartleySLC South 7124 9022 South Redwood
SLC South 7125 8595 South 1300 East Sandy UT 84070 801-566-0831 Cherrill Jorgensen
SLC North 7126 2280 South Highland Salt Lake City UT 841 06 801 4831 56 Jon Hooks
2095 East 9400 South Sandy UT 84093 801-942-4893 AbolfazlSalehiSLC South 7127
Salt Lake UT 84117 801-277-6840 Shelly GardnerSLC South 7128 2322 East 4500 South
SLC West 7129 3535 West 6200 South West Valley City UT 84118 801 9690063 Deniece Kanon
SLC West 71 30 8145 West 3500 South Magna UT 84044 8012504452 Sarah Everill
SLC North 7131 874 E 1300 South Salt Lake City UT 84102 8014864855 Steve Fisk
7132 151 West 10600 South Sandy UT 84070 801-572-01 55 Kim KomarSLC South
Salt Lake City UT 84106 8012677137 Robert DuncanSLC West 7133 1310 East 3300 South
SLC West 7134 4110 South 5600 West West Valley City UT 84120 529655325 Tyson McMillan
7135 510 East 3900 South Salt Lake City UT 84107 8012624979 E.A. ChristiansonSLC West
Salt Lake City UT 84109 8014878253 Kelli HexemSLC North 71 36 2112E 2100 South
SLC North 7138 502 E 2100 South Salt Lake City UT 841 06 8014253480 Robert Stine
West Jordan UT 84088 80'l-267-7106 Sharon HambySLC South 7140 7761 South 3200 West
Bountiful UT 8401 0 8012984401 Loren SimnittSLC North 7 141 515 S 500 West
SLC South 7142 9380 South 700 East Sandy UT 84070 801-565-9644 Cindy Jensen
West Valley City UT 84120 8019649651 James CurnealSLC West 7143 4018 West 4100 South
7144 5416 South Redwood Road Taylorsville UT 84123 801 963921 8 Rhonda BrockSLC West
Riverton UT 84065 801 -254-51 00 Cliff ChristensenSLC South 7145 12592 South 1300 West
West Valley City UT 84118 801 9660060 Elna TrolsonSLC West 7 146 6312 West 4700 South
SLC West 7147 7210 West 3500 South Magna UT 84044 8012503657 Envin Estrada
SLC North 7150 965 N Beck Street Salt Lake City UT 841 03 801 3281 348 Roger Packer
I
)
)
03/25/96 7L| 46 AT'IOCO SLCF'I EHSS ' 93598853
tt,
NO.664 PA@zv ttootslt<
Ameo Petoleum Produrt3
Sstt tal€ City Business Unit
a7a Wesl 96 Nortrr
sall L6ke (}v, u.h 841 091{94
fd+hooe; (E01) 521<810
Fa6imile (8O1 ) 54, -€52
March 25, 1996
DaleU6al
Deprrtmea of Erdromremal Quelity
Dvision of Eaviroonentel Response aad Reuedi*ion
l6t North 1950 Wesr lst FIos
SdtI*eCity, Urahtil16
RE: Undcrgrouad Stongc Tenb rt fsRalabo Oil tocetionr Eeviog Surpectcd
Product Bdeera
Dear Mr. Urban;
The followiag is a report ofR.ainbo aores having sryected rdeases fiom tieir
undergrourd storage tants or lines. All ofthe sspected releases are as a rcslt of
inveotory control. All ofthe inverory control resulr are believcd to be the resrlt of
improperDlR and MIR acmuotiog procedure.
Raiobo Oil wi[ Lnecigste dl slgeced rdcase sites (ie-, perfurm tar*-tQhtness rad line
tighoess tests) to vcriry the integrity ofall tal* systems u the listcd sores. RaiDbo Oil
Marngcrm€Dt is dso raiaiog tie DIR and MIR procedures with dl Raiobo Statioa
I{anagers to easre proper recordkeepiag procedures are being followed at dl stores.
Rainbo Oil will forvrrd the resuls of dl r^.k tightnes and lins tightness tests to DERR as
sooa as they are arailable. R8inbo Oil win abo advise DERR of atry otler follow-up
action rrlrefe neccssaryr.
Ifpu have any queCions or fitficr connccl please codsct De d 5214914.
Cul A Magurs' EavirrorlAssil*ar
Amoco Parolarm Produca db. Rah6o Oil Company
Salt lalc City Busin ss Unit
CAT.f
d{azv*
z3/25/96 \t|47 er0c0 Sr prQ EH&S ; 93598853 N0.564 ?OO4
Suspected Tanls and Lines
2
J
5
9
r3
l4
t4
l7
L7
l8
20
2A
24
26
27
3l
32
34
35
36
42
42
43
4
46
6
47
47
4c[07t2
400078I
40po779
40n0775
4-dJ[J-771
40ry.r.770
4@0770
40/./].767
4cp0767
4000766
QOATA
400a76/
4AryJ.761
4000756
&00757
4cpo76s
4000760
40o1434
4001382
4001439
400t273
4@t273
40014t6
400ar42
400t576
ffi1576
400t632
4001632
330 UT.
t77 S. l3D E sl.c, UT
*70S Higtddsl r',UT
It.ERLhhSII,UI
4l lf S Ldrrood Rd St-C, UT
89, E 66@ S. )dxry, Uf
t9/, E 666 S !r&ntry. UT
1614S 7mE SEdy, UT
l06l.t S.7@ E Sudy, UT
6& S..1@. E SLC, UT
175S. 13frESAtT
l75S 13(DESIt,UT
F22S. lcdrcodRd. W. Jadra
UT
228oS. Hlhlrdsl.C,UT
209t E 9|{n S Sdy, UT
,.r E l3{o S Sr ^, UT
lrt v. l06mS. S!ay, UT
4ll0 S.56@ rY. \Y. vdlryCty.
UT
510E39msstf,,IJI
3rr2 8. 2l@ s. sl.c, uT
qlto S. 700 E Sdy, LrT
t380 S 7u0 E Sdy, UT
,OltlY.,tlcll S. W. YdLyCity,
UT
5415 S. Dr6xod Bd frylqrvilfr
UT
3512 w.47@ S. w. YdlryCtry
35xl W..7u}S. w. VdtryCty
zl0 *I.3t(I}s lr.e-, ur
,,l0w.35611Surr,UrI
Oct-Nov'95
Ian-Feb'96
Ia*Feb'96
Nsv-Dec,95
Dec-Jaq'96
Oct-Nov,'95
Nov-Dec,'95
Dec, Jut'96
Jan, Feb '96
OA-Nov'95
Jut-Feb'96
Oct-Nov'95
Dec-Jan'95
Dec-Jen'95
Oct-Nov'95
Dec-Iaa !)6
Ian-Feb'96
Nov-Dec'95
JarFeb'!)6
Dec-Jan'96
Dcc-faa'9t5
Oct-Nov'95
Nov, Dec'95
Nov-Dec'95
De-Ian'96
Nov-Dec'95
Oct-Nov'95
Deo-Ian'96
Silver, Crold
Silver, Crold
Silver, Crold
Silver, Gold, Blue
Silver, Gol4 Blue
Silver, Blue
Gold
Gol4 Blue
Silver
Silver
Silver, Blue
Gold
Siiver, Gold, Blue
Crold
Silver, Crold, Blue
Silver
Silver, Crol4 Blue
Silver, Gold
Blue
Siiver, Blue
Silver, Crold
Blue
Silver, BIue
Silver, Gold
Silver, Gold
Blue
Silver
Gold
Tightness tess
Tightncss tess
ligltness tests
Tighness tests
fightness tests
Tightness tests
Tightness tcsts
T'rghtnes tests
Tightness tcss
Tightncss tests
Tightness tests
Tightness tests
Tightness tests
Tightoess tcsts
T"rglrtness tess
Tighness tests
Tighhess tests
Tighness tests
Tightness tests
fightness tests
fightness tests
Tightress tests
Eghtness tcsts
Tightness tests
Tightocss tests
Tightress teSs
Tightness teEts
tests
Crold = 9l Octane
Silvs = 8t Octane
Blue: t5 Octane
Note: Stations' 3,5,l?,20,32, and 35 were praniously reported to DERR on 3-lt-95
8156 SOUTH HIGHLAND DRIVE
SANDY UTAH 84093.6468
TELEPHONE (801 ) 944-01 75
FACSTMTLE (801 ) 944-01 76
December 20,1995
David Wilson
Department of Environmental Quality
Division of Environmental Response and Remediation
168 North 1950 West lst Floor
Salt Lake City, Utah 84116
CERTIFIED I\{AIL
RETURN RECEII'T REOUESTET)
RE: Underground Storage Tanla at Rainbo Oil#46 3612 West 4700 South, West
Valley City, Utah; Facility ID# 4001576.
Attached are copies of the precision line tightness test and line leak detector test
performed on July 2L, 1995 by Horizon Engineering and testing for all lines at Rainbo
#46. Also attached is a copy of the diagrams for overfill protection at Station #46,
supplied by Petroleum equipment, inc., the installers of the system at the Station.
All Rainbo station managers completed a week of refresher training conducted by Robert
S. Haviland of Amoco Marketing Institute. Proper inventory reconciliation techniques
were heavily emphasized. Attached are copies of the daily and monthly inventory
reconciliation sheets each manager is required to complete. If a manager's daily inventory
shows a variance greater thanl5 gallons, the discrepancy must be reported the area
marketing manager immediately. If you wish to contact Mr. Haviland directly, he can be
reached at, [phone].
Ifyou ha questions or further comment, please contact me at 52I-49I4
Carl A. Magnus, Environmental As
Amoco Petroleum Products dba Rainbo Oil Company
Salt Lake City Business Unit
DTRR
& REI\4EDIATlON\
ENVIRONME.NiAL ENI
CAM
BY
oEC 22ffi
Enclosure
J. E. Naccache - Amoco
J. K. Rothenberger - Rainbo
EH&S File R01.2.A
D:\DOCS\CAMVainbo46.95
\-
TE
HORIrcN
E
A Subsidiary of Arizona lnstrument Corporation
August 1, 1995
Mr. CarlMagnus
Amoco OilCompany
474 West 900 North
Salt Lake City, UT 84103
Re: Tank Tightness Tests - Rainbo Oil #46
4700 3600 West
Salt Lake City, UT 84120
Dear Mr. Magnus:
Horizon Engineering and Testing has pedormed precision line tightness tests on the underground tanksystems listed on the enclosed report. The testing was performed in accordance with the manufacturer,sprotocol as required by federal, state, and county regulations for compliance.
The testing results, presented on the attached certification page, will indicate whether the associated pipingpassed or failed compliance. lncluded with the certification is i report containing the supporting data.
lf you should have any 99_esligns regarding the attached results or any of the information enclosed, please donot hesitate to call us at [phone] or [phone].
Thank you for choosing Horizon Engineering and Testing.
Best Regards,
Pr^nl^.-
Brlan Pullan
Territory Manager
rt
Enciosures
4ll4 Eost Wood Street . Phoenix. Arizono 85040 . [phone]. Fox (602) 47O-527O
4114 Easl Wood Streer . Ptrcenix, A,zona 85040-1941 . (6021 47O-1414
Test Date: July 21, 1gg5
uT 84103
Site: g61n6o Oil #46
Conlact: Manager
4700 3600 West
Salt Lake Cily uT 84120
Horizon Engineering & Testing
CERTIFICATION
Contract No: 10584-8198-95
Customer: AmocO Oil Company
Attn: Cad Magnus
474 Wesr 900 North
Salt Lake City
Tank
No-
Tank
Product
Line Test
Bqs.ult
Passpiti
pisi
Leak Det.
Resul-t
Pass
PaG
Pass
@.000
@.ooo
o.iirio
Technician
1
2
3
Technician
Name: John Wormell
License No.: UTO2S2
Srate.' tln P
"ilj:Jl"
I
.1 DATE '7 / -qs'
Technician
Job No-
License No.
Gr:dc
purrp Type
lsdztion
R.rrrp prcssrrc
Tcst Pressure
lniti:l Lcvet
Frral Lcvd
Tifirc St:ccd
Tirnc Cornplctcd
Tcst loterrral
Lcak R:rc (@H)
tlFG & Typc
Serhl No-
Tcst @H
-
Tcst @H
r4FG & Typc
Scrial No-
Pump and
dispcnser
operational
EXISTING LEAK DETECTOR TEST
NEW LEAK DETECTOR TEST
AFTER TESTING
S
f RIZON LINE TESTING t^- i'N SHEET 1
653?
Customer
Location
City. State
4
ffifi' Hfi' ffifi' 'frfl] 'f,f,, 'fl
( vcrify th:t thc dspcnscr(s) work noimally aod that the le:k
Cf
-€,,c|<{
Qnr-,,,n
/zJ
&tutr
2r/
up 4o Yd
-09 - ogso ,68
-oe . a$9o ,OB
lo''^*/ /*e-!t"*
/ Ou{au l/*n-t7 ,{
Prt
30-,*.9x,q.
ooo.. aoD 0oo
Yffoot.l:s.s -X4o xLn
x(xo {,{,xxxx ;00fi kqrt trs,t
Pass FailEE Pass FailEE Pass FailEE Fail
E
Pass FailEE Fail
E
PassD Pass Failrt tl Pass FrilfrD PassE Fail P.stD :il Pass FailEE
Yes Nowfl Y.t NoNE Yes NoEN Yes NoEE Yes NoErl Yes NoDE
Field Notcs:
Managers signaturc
) are lcaklng
I
I
Qro,rt,,"IrA,^ t
P:Pr
6t,rh-Alrll *-
2u
?ion,n
t7/74/9=
t7/14/9=
LZZZ?
7?tZt PETi
EA1 487 t?95
:Ul'l EGPT SLC -+ 881 521 49ES tra1\- ,:rir,,
PET ROLEUITI EOUIP}IE HT COTrr
1 1 74 $ourh 300 west r satt laka city, urah .E4101 r (801) 487-827A r FAx {801 ) 487 -9795
PLEASE DELIVER THE FOLLoUUltrtG pAcE($) TOr
(una
f L[ar'-,l/*
FA)( NU {Ll-G{
SUE'ECT
lF You DID Nor REcElvE ALL PAGES, PLEA$E GALL
(t01)487{276
ADDITIONAL NOTE$:o (
Mailing Address;
P. O. Box s10107
Salt Lake City, Utah E4151 ;Pii,
'"q:rJ'
,t
TOTAL T{UMBER OF PAGES IilCLUDING COVER
PAGE; 3 ,,,-
DATE: LI . L4-q5/
77/1,4/95
"'
1,t/74/9=7?t AI
EAt 48? 9?95
:Ul4 EEFT sLC -+ 841 52r 49EsPETt
41000-
, Aute:rrratia Oyerfill preyention $3lstemtanlrole lnetallation lnstrucflonsA10oo{XI1 Goaxiat
41000{rOZ Duat
A10m{0S Coaxial with VaporVafve
Nrl.514 D@2
Ni
fiTEP 1. Tank Bis6r Pipe trngth E*E FroutE
1.1 MeaEUre tEm graOe Crrci m tne-top of ne tanXbushing, L"Gfigth %".
1.2 Add crofii hcight (Lengh "B'l !o hngrh,.A.
ror t€ngth .C-.
NOTE; Lengttr .8" ic lo be 2l minimum
1.3 Addtfis Yah,t langtt "D., (Al inchG6) and
36tding l]louancB (Lengilr "B) to gter
Length'F
NOTE: Settling allotran@ rEquircflrents depend uooneil,e tocation and are to te esUbti+ireO tV -tfre
contrasbr.
1.,{ Plbrrac-t ten$h ,,F- fnom tarqgth ..C. for tength'Gi" for the dErence betwn the tsnk bushini
end the rerlill valw body.
NOTE: Pipe is to be Length ,G. plus threads-
1-S Meke up riser pipe/iank ioir[ with a peImsne]rt
thrcad tock s6alant sush aE Locrih drede 2|./for Perma-Lok Grede HM 129.
funpla:
1. I qnk h buricd 36't um gr.de tevel and Uretrnk blr3hing is I inct high.
t€ngth .A" is A5 anches
2. The s,iB requirer a crwn of g. ftom grade lodm rop tor ruI}ott.
I,engtir -8" is Z inches
3. The sab requar€s a I incrr ot s3tflangt nSOr "E is t inctt
Gafcrrlationc (tb Flgue l)
I. __(:A:) + ("8") - (.s)
S5irtchea + zinches = g7 inft
2.
3.
('D") +
21 incfies +
('c")
37 incfies -
("E"t
I inch
("F)
22 inches =
("F")
22 irrclrcs
('G')
15 inches
The length betwn the bushing rnd oErfil yahc lDis 15 inches-
The finished il- pipe riser ihould b6 1Z' ,ongthEaded ofi both endr.
TH'B''
2" MIN,
LENGTH
,i
;:\
i
I
Il
I
I
!t
I
I
Ii
II'l
I.t
.t
rl
LENGTH"r
LENGTH
F
LENGTH
A
t'
IL-----
TAHK
BUSHIilG
*--,J VALVE
RISEF PIPE
LENGTH "G" +
tt
I
t
THBEADS
5Aq6/q
,
L7/L4t35
"'1.t/1,4/9=PETI
12: E3
7?zOZ
EE1 487 9?95
:Uf4 EEPT SLC -+ EEl 521 4955
INSTALLATION
PLATE
4" COUPLTNG
& NIPPLE DRAINAGE SLOT
CBOWN
GONCRETE
GRA LEVEL
N8.514 DAs
STEP 2) MANHOLE TNSTALLATTON (Figure E)
2.1)
2-21
Sct menhole rim/slBeve over ri8er.
lnstall a 4" NPT coupting with a 24', long
nipple on the risor pipe. Turn on hand
tight only.
Sel top of manhole rarn Length',F,,(from Step
1.3) from bottom of 4,,coupling a$ shown in
figure 2. Sst Length .F" by Uaiftifling under
the sleare.
Place the inslaltation plate over the 4.,nippte
and into the manhole rim to center it with the
riser pipe.
BaEkfill around the sleeve to depth required .
for concretE pad thicltrress_
Set forrns. Pour concrete and strike o*
"ro*nfrom the drainage $totB to grade Evel. Removu
excess concrete from drain slots and inside
of rim,
Femove installation plate and discard.
Remove the 4" coupling/nipple and save for
future inrtallations.
Apply Emco Wheaton Zg threao sealant to the
riser threEcle.
Color eode paint lirl/rim as required.
2.3)
2.41
2.5)
2.6)
2.7)
2.8)
2.9)
2.10)
?300 lodusr/iol Onve
P o €or ?28S
Wr;ron NC ?7Egl
tq rg, 243 0150
,l
ll,
l tr'
a.a
!r..r.l'f r,'
: j,,: i...
LENGTH
'iFil
BACKFILL TO
SET CONCRETE
THICKNESS
SLEEVE
BACKFILL TO
a
I
a icoNCHErE
n
-\
I
r.=l
.)(J
15
I
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FIGUHE 2
SET LENGTH "H"
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r / rS-r TrlrJ r.l-rVI t
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3 oTOTAL
PIEY.
rorlL
PEEY.-J
AVE PN,,GAL
totl R3
PB€V.
30tD 3()to b
r r lr5r7r lt?tOr3
AOLD
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DOLI Btt 8r?.ra rx)ttlRS lr s,DOtt^n3
AYE. PRATIL l-?(AVE PNJOAL /. zc AYC PN,'GAL
orL otL cAL olL
IESI mttamt lx)tLrns ooltanS
s'Aro,, - lL3lt D ,G.-- ilnh*--
triG or pnEr clr^rrr .lodl, I9P6l
PUMP IOtALlrEX rltAu,Nus twng,. rtrf,orrr,
rrx)i, __ q249! rc- -t/Se/75.- -
ll(,rrEooY l-:#;;:', IIrlf
R.lMP PLilPI Pt,UP
a(r.lt.
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f E @lhrf,t, tm Fdtqn dr, lttr
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lO raa n su?ts ratorrm 6 to qnu|.irt wrrt El
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Month Dealer Narne Service Statiorr Arlrlress Service Slation Nurrbcr
lnventory Control Program
Monthly Reconciliation Worksheet
34- 1023 {7,93)Ultimate (Goldl/Premium Silver/Midgrade Blue/Begular Diesel
1
Cunrrrlative Monthly Over (Gain)lShort (.oss/ Gas Gallons
(Refer to your Daily Liquid Motor Fuels lnventory Record far the
last day of the month being reconciled and use Line #15,).
2 Total Monthly Gallons Sold
Regulatory Variable Gallonage (See calculation examples below.)3 *
' Tlre calcu (e Line 3. represents a volume loss or nage, which may indicate a storage tank system. lf Line 1. shows a shortaglethat is e ual to or r than tllis call
4.OJrening Tank lnventory (Previous Month's Ctosing)
5.(+l Total Deliveries
6.(-) Total Monthly Sales
7.(-) Closing Tank lnventory
I Monthly Product Variance
'\.moco
)ock Ledger
deconciliation
lnformation
(in gallons)
Calr;
for a
trlatiorrs are to be cornpleled for
oduc ou must com Ste 1., 2., and 3
you two or more tanks
and the Amoco Stock Led r Reconciliation lnformation
r, you count them as one tank. However, if have two or more tarlks rlot togetlrer
for each tank.additional forms if n
ulation
Examples
For tlre calculations, we will show both an
Both ex a calendar month as the
Exanple A.' Fsdsral (tolo of 'flow-thru' + 130 gallon:t
!.,-!ljnrato
l.CtrrrrrrlativeMonthlyOver/SlrortGasGallons,...... -5OO (tine#1.)
[otal Morrthly Gallons Soldt . . 2O,OOO (line #2.)
3. Rrrryrrlalory Variable Gallonage. . 1% of 'flow-thru. + l30 ga[ont lline #3.)
" Note:
To r;trlcrrl;rle line #3. (above), rake your Total Monthly Gallons Solrl lline #2.) and multiply by .01 (1%),(soo Calculalion A)
tltis will give you a figure of 200 _gallons. Next, adrl 130 to the 200 gallon ligure (l% of 'flow-thru" plus 130gallons). The sunr of these two.figures (200 + 130 = 330) 330 galldns, repfusents this month's RelularoryVariableGallonage.foryour"Ultimate"product.r* Nowlookatl-ine1. Th6servlcestationCumulativeMonthlyOver/ShortGasGallonslor"Ultimate",showsalossof500gallons. lnthisexample,becauseline#1.(500gallons) is gre_ater than line #3. (330 gallons), you have oxceeded your Rogulatoiy Variable Gallonage lor thisrnonlh as set forth by law, and you must cal! your Territory Manager lmmediatety.
Variable Gallona set lorth by law I tei
Example 8.- Stsro (t/2%l
Ultamato
l.Cunrulative Monthly Over/ShortGasGallons.... -140 (line #1.)
2. Total Monthly Gallons Sold 50,125 (line #2.)
3, Begtrlatory Variabls Gallonage . . ll2o/c l.OO5l (line #3.)
To calculate line #3. (above), take your Total Monthly Gallons Sold llina il2.) arrri rrrultiDly lty 'l/Z'ri, l.O}til,
lsee Calculation B)
lhis will give you a figure ol 250.625 gallons (Whenevor you have a f igure that is rrot a wholc nunttrer - as in this
case "250.625 gallons" - you should round down to tho nearest whola number. ln our currerrt calculation tlre
whole number you would use after you round down would be: 250 gallons.). ln this exarnltle 250 gallorrs
representstheRegulatoryVariableGallonageforthemonth.'r Lookingalline#l.wecanseetltatweltaveir
cumulativenrr:nthlyshorlageof 140gallons. Bocausethelossof productforthenrontll{line#1.) islesstlrart
250 gallolts (line #3.; the Rogulatory Variabls Gallonage, as calculated), you are below tlre rel)orting tlrreslrolrlforthis month. l, this is lhe case, please complete thisform and mail lhewhita col)y to yorrr srrpplyirrg lerrrrirr;rl
Chock your local rogulations {or Bny additional action you nray be required to rake.
of month uct.
Notification
to Amoco
Territory
Manager
by
#'l
no
#1 ) to the "Regulatory
#3. and submit the
rge" as
is formrequired lor line while copy o{ lll to yorir sul)l)lyirr11 terrtrirral
on your part (unless required by your stato)
the lerleral guidelines (Exarnple A) and an exarnple where a state law has requirod a 1/2% {.005) corlltarisorr (Exarrrpk: h}).
ete
rer;ulatiotls in its laws. Therefore, it is important thal you consult your Territory Manager to determinir tho current compariton iigure being used in youi stato-
Calculation A
20,OOO (line #2.)
Calculation I
50,125 (litre #2 )x .005
250.625
Round to 25o
x .01
200.00
+ 130.00
33O.0O (line #3.)
Dato Tirrre
Person Notified
Beport Received (Amoco Representative's Sionature)x
Th accurate
to formhis
period
of
Comments
and ct the
Distribution: White - Ternrirral; Yellow - Service Statiorr
MIH
7aYou Used
Irrverrtory control Progranr Morrthly Reconciliati,, wr.rrlrsheet
I lrc pttrposc of this fornr is to oolnl)aro lly.1.)r0clrrct, tlrc "crrrrrulative Morrtlrly shortage.in Gallons (Line #1.) to theRellrtarory variatrte Ga[ona11e (Linb #3.].'Wr,"n vdr; ;,,;;;:i;ii;;. ;il;;iiil ;i ;.i;,s" is equat to or sreater rhan rheRegulatorv Variable Gallona[e, it is a sier,.' tr',ai vi,i,-,;r;';iii;i,]'i,*"']"r3ri[ii'lil'ii;articut'ar unoergiolnd storasetank' or arr error irr calculatio"r,.,r,.'"us,ircrrrcnisorrrctiirrr: rlrrrirrg rhe rnorrrh. rr;c[-iiiaii;; M-i;ifiiy"Shortage,,isetlttal to or Qrealer tltan the Rusrrlatory variarte caii;;;;i;;;';;rr jrus, inrmediiie;;ili;;; ffir'J%ij,rrv Managerby pltone or similarly rapid rnelrrt.rf i,,i't,n,,rrricati.n. in'l1i,iirin,.,, a copy of each nro,th,s completed form arrclcalculations mttst bekeptf,r a periorl orat li:nsi o-;; y;;;*;iiiror ar yorrr'service station ora place readiry avairabrefor irrslrections by yourirnprer,bntirrg Jg"u,,y aro i"l,:iiii,y'iirtr,,ug6i. -"
Proceclures at th6 close of each nronth.
1' Enter Month, Year, Dealer Name, Service Station A<.ldress, arrrcl Service Station Number.
2' Ettt0r ycltlr CutnulativelVlorrtllly ovcr,/sltort Gallr.rnl;1or cltr;lr;lrorlrr:t on Line #1. Refer to your Daily LiqriclM,tor Fttels lrtventorv Rec,rtlior tlrrr t,,ri,i,iy ni-ii;;,,';,;,;;;ii, r,"i,,ri ieLrrii"ii"j r,,,r,,sJr_iii"'+is.l;;irrts stesr.
3' Etttr-:t yotlr Total Montlrly Gallons Sr.rlrl lor c;tt;h prorltrr;t 6rr [.rrrr: #2.
4' Determine your state's,cttrrent "Reg.rrlatory Variat:le Gallonage', comparison amount and time frame.(Ttris inforrnation sltottlcl be availalit,, iri,r'i v*,r iorrilJrrT'ruonrgo," )b;t";i;;for the Regularory VariableGallorrage amourrt ancl erttr:r this fieure o. Line *i. rxri,i,irr,,s oicaici,taii,r;;;ru given in the sectionentitlerj "calcuration Exarnpres" on iire rront oiirii, io-r-. "'
5' lf yotr ltave a shortageon Line #1. that ecluals or exceecls..l,lre Rcgulatolv Variable Gallonage anrount (Line #3.),contact your Terrirory Manager inrnrediatbly. conliiiu" *itt, steiis z-ro] - -"
6' lf youlraveattovera-ge-^r:nLine #l.,ctr.ashortago.tlratdoesnotequal orexceedtheamountonLine#3.,continue witlr steps z''t0. (check vour tocaliesuiaiionlrl,. any 6661;-fionJiriiion you may be required to take.)T ctltnlllt:te llttl Atnrlco st0t:k [-etl1;r:t Rer;tttrciliatiorr lrrIorrrrirrio.rr.for each prorltrt:t. Recorcl the rn.ntlr,s operrirrg
['latr:c Llte Iinal figure ir.t tlre-st)acr].r,'fitl"rl. vr'.iiir,rvFioiiii,,t vuriarrce,,(tirrc #8.). (Note: tlre M,rrrlrlv proclrcr
I\4orrtltly Protltrct Variurrt:e lt-irre #B.l rrray tii,, arr i,,itic,rriii tlr;rt errors exist ii the reading, enterirrg;, orcalcrrlari,rr oIyottr daily figures. You slroulcl recheck ybur daily e,:,iii"r for possiSle nristakes.)
t
[;X;1,11'il,i,i[}|'r['J',i',,!3|]i;?l'ins water drawrr lr<,rrr lrrr.rrttrcr r,rrks, rorarizer nrobrerns, erc., in the space
9. Read the signature statement ancl sign form where irrrricated.
10' Send lhe white copy of this form to your supplyinll rerrrirral arrd keep the yeltow copy for your statioRemerttber, all statibh copies must bd i"pi"[Tiid'iii vi,i,i rorvir:c station or-in a ptace readily availabteinspection by your imprei-nenti.g age,rcy a,xr reiriiliy itio,,utJ",..
)
a
a
)
Michael O. Leavitt
Govemor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Director
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West lst Floor
Salt Lake City, Utah 84116
(801) 5364100
[phone] Fax
(801) 5364414 T.D.D.
Date November 20,1995 4 *- r.-,r,(" i '*;j
TO:Amoco Oil Co. dba Rainbo Oil
Attn: Carl Magnus
8156 S. Highland Dr.
Sandy, UT 84093
RE:Non-compliance of underground storage tanks at Rainbo #46,3612W .4700 S., West Valley City, Utah;
Facility l.D. #400157 6.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary ruST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and
federal UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation
(DERR) performed a compliance review for the underground storage tanl6 at the above facility. The compliance
review, performed on November 13, L995, indicates you have not satisfied the requirements of the Act ind are
of compliance. To achieve compliance you must do the following:
{fr;
DK
1. Submit a copy of a current precision line tightness test for the product lines associated with tanl{s
#1.2. & 3.
2. Submit a copy of a current annual test for proper operation of the automatic line leak detectors on
the pressurized product lines associated with tanl$ #1.2. & 3.
0l/ S. Submit documentation verifying the instaltation of overfill prevention on tanks #1.2. & 3.
/kO. Submit evidence that proper Inventory Control is performed on USTs #1.2. & 3 byz"rl
a. Documenting that inventory records are reconciled monthly to determine the total overage or
shortage for each UST, and the variance is compared to the allowable of 130 gallons plus one
percent of the UST's monthly throughput*.
b. Documenting that the Automatic Tank Gauging (ATG) systern, you nse as a gauge stick, is
properly installed, calibrated and functioning so that it is capable of measuring product level
to one-eighth inch.
c. Documenting that the water in each UST is measured to within one-eighth inch, at least once per
month, and the water measurements (converted to gallons) are used to correct the monttrly
inventory reconciliations.
*NOTICE: TIIE FEDERAL LAW (40 CFR 280.50) STATES TIIAT OWNERS AND oPERAToRs oF
UST SYSTEMS MUST REPORT TO TIIE IMPLEMENTING AGENCY (DERR) WITIIIN 24 HOTJRS
ANY SUSPECTED RELEASE FROM TIIE UST. IN TTM CASE OF II\IVENTORY CONTROL, A
SUSPECTED RELEASE IS INDICATED WHEN TWO MONTHS IN A ROW ARE NOT RECONCILED
WITHIN lVo OF THROUGIIPUT + 130 GALLONS (PLUS OR MINUS).
Printed on recycled paper
v
Please return a copy of this speed memo with the above items to speed processing. The above information must
be submitted to this office by January 20r 1996. If it is not received by the date specified, we will commence
the revocation process of your Certificate of Compliance. If you have questions concerning this matter or need
any assistance, please contact David Wilson at [phone].
Novcmb€r 2r. ree5
:4,
Michael O. Leavitt
Dianne R. Nielson. Ph.D.
Executive Drector
Kent P. Grav
Govemor
Director
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West lst Floor
Salt Lake City, Urah 84116
(80r) s36-4100
(801) 359-88s3 Fax
(801) s364414 T.D.D.
Date November 20. 1995
TO:Amoco Oil Co. dba Rainbo Oil
Attn: Carl Magnus
8156 S. Highland Dr.
Sandy, UT 84093
RE: Non-compliance of underground storage tanks at Rainbo #46,3612 W. 4700 S., West Valley City, Utah;
Facility I.D. #4001576.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and
federal UST statutes, rules and regulations.
At the request of the Executive Secretary OST), the Division of Environmental Response and Remediation
(DERR) performed a compliance review for the underground storage tanks at the above facility. The compliance
review, performed on November 13, 1995, indicates you have not satisfied the requirements of the Act and are
out of compliance. To achieve compliance you must do the following:
,nt-t,/g O/0. Submit a copy of a current precision line tightness test for the product lines associated with tanl$
#1.2.&3. Don_ 7_zl-?f
OkCl K Z. Submit a copy of a current annual test for proper operation of the automatic line leak detectors on
the pressurized product lines associated with tanks #1. 2. & 3.
3. Submit documentation verifying the installation of overfill prevention on tanks #1.2, & 3. ?
Q{Urf n. Submit evidence that proper Inventory Control is performed on USTs #1. 2. & 3 by:
a. Documenting that inventory records are reconciled monthly to detemine the total overage or
shortage for each UST, and the variance is compared to the allowable of 130 gallons plus one
percent of the UST's monthly throughput*.
b. Documenting that the Automatic Tank Gauging (ATG) system, you use as a gauge stick, is
properly installed, calibrated and functioning so that it is capable of measuring product level
to one+ighth inch.
c. Documenting that the water in each UST is measured to within one'eighth inch, at least once per
month, and the water measurements (converted to gallons) are used to correct the monthly
inventory reconciliations.
*NOTICE: THE FEDERAL LAW (40 CFR 280.50) STATES TIIAT OWNERS AND OPERATORS OF
usT SYSTEMS MUST REPORT TO THE TMPLEMEI\TING AGENCY (DERR) WITHTN 24 HOTTRS
AIYY SUSPECTED RELEASE FROM TIIE UST. IN TIIE CASE OF II{VENTORY CONTROL, A
SUSPECTED RELEASE IS INDICATED WIIEN TWO MONTHS IN A ROW ARE NOT RECONCILED
WITHIN lVo OF TIIROUGIIPUT + 130 GALLONS (PLUS OR MINUS).
Printed on recycled PaPer
please rerLrrn a copy of this speed memo with the above items to speed processing. The above information must
be submitted to this office by January 20,1996. If it is nor received by the date specified, we will commence
the revocation process of your Certificate of Compliance. If you have questions concerning this matter or need
any assistance, please contact David Wilson at [phone].
November 2r. r,,5
lllosJ-tuld'rop.d6uf,v\olp^'UUIO-.ilqM :uoluxlrlsro
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lseqcu! u!, luat u! pnPoro lo qpaP -asn u! tou ll
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sN ao^"t't L_".D"N (-:DoNocualpuro] lo alscllluEc uo p€t3!l luEI
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I
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ffififfi*Etrffidqfffi*ti
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stffi*ffiffirffit
rq\
t6)
Tank I Tank2 Tank 3 Tank 4
Yes @_ves @_-Yes d€Yes NoThe UST system is filled by transfers of 25 gallons or less. lf yes, spill
and overfill prev€ntion is not required.
No@ '@ Nb No@ Yes No
Yes /@(----Yes NoxYes@Yes@
(i. t{ nine), {lgr, or other
lfloat
ls there an overfill prevention
indicate the type ol device:vgll!!e), Automatic shutdff
on the tank? lf yes,
Yes No Yes No Yes No Yes' NoFor overfill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Tank 1
Yes No
Tank 2
Yes No
Tank 3
Yes No
Tank 4
Yes NoFor overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
ef)-Tmk,?)
G
. Trr*(a)
fr<p rkr fr/lndicate the type of corrosion protection: Noncorrodible material (FRP),
Composite steel (CS), lntemal lining (lL), lmpressed Current (lC),
Sacrificial Anode (SA), or Not protected (NP). It FRP or CS do not
complete the remainder of this section.
Yes a_Yes @ Yes @ Yes No
lf the UST is not prot€cted, was the tank/line installed belore May 7,
1985? lf yes, corrosion protection is not required until Dec. 22,
1998; do not complete the remainder ol this section.
Yes @ Yes NoYes@ves {Q*The results of the last two cathodic protection tests are available.
(within 6 months of installation and every 3 years thereafter).
Tank
volts
Tmk
volts
Tank
volts
Tsk
volts
Llm
volts
Llre
volts
Um
volts
Llre
volts
Results of the most recent cathodic protection test.
a
Name of
TeSt
Yes NoYes No Yes No Yes No
For impressed current system: The results of the last three
equipment operation checks are available. (Equip. check required every
60 days.)
<7t
lnspector's Signature
meets 1998 upgrade requirements
,1
o,
I
tank(s)#
Loo
! Spill prevention for
Signature of Owner or Owner's Representative Present During
understand thal the lollowing marked items must be completed by
4oo
Date
p Conosion
fl Conosion protection for piping assoc. with tank(s) #
ll the tank has been retrofit (lined or cathodically protected), indicate
the date the retrofit was completed.
(p[m mm)
December 22, 1998 in order to meet thb 1998 upgrade requirements:
I Overfill prevention lor tank(s)#-
Distribution: White-DERR,
ls there a spill contafrrmenl bucket or another device that will prevent
release of product into the environment?
I
Llm
I
?
la
1
Set 1 T.t* I TrnI 2 T.i* 3 TItt /t
Automatic Flow Rostrictor (il yo6, indicdo modal in commonts ssction)
xK'r Y
Aulom.tlc Shut-oft DGvic6 (if y63, indic.t6 modol in commont3 3ection) )
Co.rtinuouc Alarm Systom (iI yes, indicat6 mod6l in commentr scction)
Rscords of lost Lin6 L6sk Dgtoctor porformanc. t63t aro avaihblo on-sito Noa No_@ @No Yr! No
O!t6 of la6t Lin6 L6ak Dotoclor portormlnco t68l 7-Z*?y ----2
R€8ult ot l.6t Lino Lo.k D6t6cto, podorm.nco t€st 6'fae! rait f,rrE, Fsil rEa8&= Fsil P.8a F.il-...-
R6cords of last Lino Tightnes8 Tost r,o availablo on-8ito No@ @ r'ro -@ tlo Y6r No
Dlto of last Lino Tighln6s6 To6t 7^ 26-7/
---Result oI lsst Lin6 Tightnoss Tost .@r"u @ r"ir - Pf!r. Fsil P68s Fail
company ol cenilied uetat A.,'^r,,aA T4lt/.-.^"-l i /Alrt /kt^Utah Tsstor corrification Number: UT INamo and
V6por Monitoring (if yos, use Vepor Monhoring checklistl
G,oundwater Monitoring lif yo8, uso Groundw.tot Mgnitoring chocklistl
lntorstitial Mo_niloring (if yos, wo lnterstitial Monitoring checklistl
Statistical lnventory Roconcili.tion ISIRI (if yo6, u6o SIR chscklist)
Other approved method (if yos, use olher m6thod checklistl
Rocords of lsst Line Tightngs8 Test ara blo on-sito Y66 No
1-!it!-r!,,,+-]!
Yes No Yo8 No
:*-:i:,?!i:i.F..r-i!E--,E!l
Yo8 No
D6to ot last Line Tightn€ss T€st
Rssuh of la6t Lin6 Tightnoss Ts6t Pa6s Fail Pa88 F.il Pas6---fuf-Pass Fail
Vapo, Moniloring (if y66, us6 Vapor Monitoring checklist)
Groundwaler Monitoring (if yo6, use Groundw.to, Monitoring checklistl \
lntsr6titial Monitoring (i, yos. uso lntorstitial Monitoring chocklistl
StatiEtical lnvontory Reconciliation tSlR) (iI y63, uBe SIR checklist)-/\
Othor approvBd m€thod (iI yes, use bther method ch6ckli6tl
Opgrato6 at l6E6 than atmoEphoric pro66ure
.--------lffi!E!FF.
lltir.tili:i;:iri:iri:ili'ii::ii
Y€6 No ETIIE!Y6s NoYs6 No
Slope ot piping will tllow ALL product to draj#o tank when euaion is
roloas6d -/
Y63 No Yes No Y6s No Yes No
H.s only or{E ch€ck v alve, locg*{rectty und6r pump Y66 No Yes No Y6. No YoE No
-/'All abovo information ofsuction piping is VEBIFIABLE, ua€ commonts
s€ction bolow to documont how it is vorifiable.
Yes No Y6s No Y6s No Yqs No
Dal6:
a
+I <-...
t/-/3-2 4^\
Commonta: ,<
Co
Signaturo of Ownor or Ownsr's Represontative Presont Duting lnspsction
lnsp6ctor's Sign8ture:
SlG
Oi3tribution: Whit6-DEBR, Yellow-l r, Prn
This method ol leak detection requires both monthly inventory control reconciliation and tank tighhess testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from conosion and that spill and overfill prevention devices have been installed) the tank needs
to be tightness tested annually. ll the UST is upgraded the tank needs to be tested ryery live years.lnventory records must be kept lor each operating
day
Record of last Tank Tightnoss Test available on-site @No @No @tto Yes No
Date of last Tank Tightness Test E-z/9(
-
-
/FeSl-FailResult of last Tank Tightness Test. lf fail, specity in comments section what
actions have been taken to correct the problem. Has DERR been notified?
@Fail @Fair Pass Fail
Tank Tightness Testing method: hO/, ^ , / ., '.
Name and company of tank tightness tester: HOrr'a O - - Groa Prfh' t Utah Tester Certification Number: UT
Documentation of performance claims for the Tank Tightness Test method is available and shows the ability to detect leaks of 0.1 gph
witr 95o/o or greater probability ol detec{ion and 5% or less probability of false alarm (3rd party certificatlon)
lnventory volume msasurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
No No No@
Qru"
Yes No
Jnventory is 4lconciled monthly (sum of daily overages and shortages for each
month is less than 1olo of tank'b flow through volume + 130 gallons)
Yes @ Yes @ Yes -a Yes No
ll no, which months were not? (specify month and year)6%tu1 T-rqz-rF t-G/e-x ,tril
lnventory Control records are maintained and available for the past '12 months
for each tank
No@ E-"@ t'lo Yes No
Records include monthly water monitoring to the nearest 1/8' 4f 6 -6i No Yes No Yes No Yes No
I Uontnty water readings are used to adiust monthly inventory balances Yes @ Yes @ Yes G Yes No
Appropriate calibration chart is used for converting product level measurement to
gallons and is available for review
Yes udn Yes q Yes {q Yes No
Dispenser pump has a current calibration sticker or appropriate documentration @No 6'J\ tto @_ *o Yes No
-Y,€S\ No-.--
'i.ii:i..iiiiiiiiiiiill.i';.... i, ;ii:i . i:
@Owner/operator can explain inventory control methods and figures recorded
No No
No
Yes No
Books appear used and evidence of recent entries is apparent _@ No
Owner can demonstrate acceptable gauging techniques <Y6S\No
The gauge stick is long enough lo reach the bottom of the tank @ No
The ends of the gauge stick are flat and not wom down @ No
The gauge stick is marked legibly and the product level can be determined to the nearest 1/8 of an inch over the full
range of the tank's intemal height (9 No
dro
+Comments e4/
Signature of Owner or Owner's Representative Present During
lnspector's
Ot'a,n .aor///y
Date:
Distribution: White-DERR,
UTAH UST,irPnOGffiM.
And
:F,anliity:tfB'
Tank Contiol
ptease CtrClC'YCs or No for eaCh::qtosilon lor eich tank ' use aootlonst lonns::u'nEcees+y ir more tie1 folr rark&
Tmkl Tank 2r lilKiTleflT,,l{ESS,,|IESTING Tenk 3 T{nk *
TCnk I Tsnt 2II$VEHT0BY.,CQNTBpLI .?ank $Tank,4
@
The drop tube in the fill pipe extends to within one foot ol lankbollom //$
Pleas€cli#lc,iivcs i ri,N,o,ifry:Eeehiifi ucstlon
!
t-t t-t i-t i-t J t-\ \-,. ,-t i-t J r-t ,-(\-r J J t rr
r-rg7r{l Ttace r Rcsctrtl CorTortliot
CARU'ASH
STORE
V.Dtrooo
EXPLANATION
. I Sahpliug Probe l,ocation
Approxlnatc Plpelioe Locatlou
t?
RAINBOW OIL
1 .8
Pump Ie laada
.2
't
N
7?
210
Lrrf-J
tCC
.6
.10
.9 .lt
I
soLuH 3600
L.AXE CITY.
sAuPLtlic LocATIoNs
)
tet lo
trlr
12.000 gal
Unlcadcd
DDX
12,000 gal
Supcr
11,182
t.rl Io
nll
r
1?,O00 3alRegular tr
DDU
lul Co
tl!
Puap IslaDdE
a?oo
srL?
Figure 1
rf,sT
UT^E
(
m
I
I
I
I
I
I
I
I
)
,13
Manufacturer, name and model number of
Tank I -Tank 2 Tank 3 Tank 4
Yes @ )yes @ Yes @Device documentation is available on-sits (e.9., manufacture/s brochures, owne/s manual)) Yes No
Records on site document that th€ system was installed, calibrated, and maintained
according to the manufacturer's instructions (if no explain below)
Yes q Yes q Yes -@ Yes No
A probe is present in the tank (checked by inspection)(f5O No @_No @No Yes No
Device can measure the height of the product to the nearest 1/8 of an inch ?Yes No Yes No Yes No Yes No
Yes No Yes No Yes No Yes NoDevice monitors the in-tank liquid levels over the lull range of the tank's int€mal height ?
A monitoring box is present and there is evidence that the device is working (i.e., the OevicCt
is equipped with roll of paper for results documentationl I <.2 O>nG,f
Yes @l<e r1,-Yes @ Yes -€-Yes No
'""4/X ,/?/4
Yes NoDocumentation is available demonstrating that the Automatic Tank Gauge was in leak test
mode at least once a month for the last 12 months
Yes No
/1+L
Yes No
lf no, which months are missing? (specify months and year)
The tank was filled to at least the minimum level required by the manufacture/s equipment
protocol to ensure a valid leak test
Yes No Yes No Yes Yes No
The tank capacity is within the upper and lower size limits required by th€ manufacture/s
equipment protocol to ensure a valid leak test
Yes No No Yes No Yes No
Yes No No NoHave any of the leak test reports indicated a failed test. lf tail, specify in comments section
what actions have been taken to correct the problem. Has DERR been notified?
Yes No
Documentation of performance claims for the automatic leak test feature is available and
shows the ability to detect leaks of 0.2 gph with 95% or greater probability of detection and
5olo or less probability of lalse alarm (3rd pafi certification)
No,"J,No Yes No
0t
+
Comments:
rc
Signature ol Owner or Owner's Representative Present During
lnspector's S
Distribution: White-DERR,
.' $"fi
!
l(,ooo
Iq.OS 9EL8
IVIVd
AllJ/r{M {asra^eu eesl
llBl\l leuorleurelui rol asn lol/ oo
Pog!^old o6era^oO acuetnsul oN
[en po!#uec
rcl ldlecaury
$
ssarppv s,a.ssorppv ple ,areo
uoqM ol Buhoqs ldl€la! urnBa
p.r.^rEo .leo t uoq/v\ ot
ouraoqs ld'..a! urnrau
.al tua^1€o polcuEeg
seLsLoorll -:Ff-
,6?rsoa
I ln ' APUeS
.poJ dtz pue atels ' o.a
,60n
EhZ EEl TOE IE
. ComDl€te ,roms 1 and/or bddltional servicos.. Compi€te itims 3, and a6 _,/7. Pri.t your n.me and address on th€ rcvarsa ol this ,olm so that we can
r€turn rhis card to you.
. Attach this lorm to tho front of the mailpi€ce, or on the back if space
. w te "Betuh Beceipt Requested" on the mailpiece below the anicle number
;"rt*",*"..
*"i,lt{/ti ifow to whom the anicre was derivor€d and th6 dat6
3. Article Addressed to:
PAUL FIARBANKS
E DER:
A|YOCO OIL C0. dba RAINB0 OIL C08155 S0UTH HIGHLAND trR.
SANDY, UTAH 84093
FA
5. Signature lAddressee)
I also w,
following se.
\to r€ceivo the
Js (for an extra
fee):
1. ! Addressee's Address
2. n Restricted Dolivery
Consult tmaster for tee
4a. Article Number
P-1
d
.9
oo
o.'6
o
G,
ot
o'
'dt
o
:,o
t!EF
4b.tr rvice Type
istered I lnsured! coD
T] Return Becsipt for
ertified
E Express Mail
7. Date ol Deliver3-
8. Addressee's Address (Only if requested
and fee is paid)
11400157 6
, Decemb 19 nu.s. cPo: ree2--32re2 DOMESTIC RETURN RECEIPT
I
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Rainbo
L(W I5DL
'..*1H DEPARTMENT OF
Ei", rt'tONMENTAL OUALITY
SEP3(l Ig$JT
DlV. OF lii',!, ii :'11'
,IE$PONSE At'lD hbir,--';'r *ld
8156 SOUTH HIGHLAND DRIVE
SANDY UTAH 84093-6468
TELEPHONE (801 ) 944-01 75
FACSilVTLE (801 ) 944-01 76
September 28, 1993
Mr. William Moore
SEaEe of UtahDivision of Environmental Response and Remediation
Department of Environmental QualitySalt Lek Cit,y, Ut,ah 84114 -4840
Rainbo Serrrice Station #45, 4700 South 3600 West, West VaIIey City,
Utah, Telephone ConversaLion of 9-27-93
In accordance with our telephone conversation of 9-27-93, please
find att,ached pump calibrat,ions performed in L992, and 1993 , for
the subjecE site.
Should you have any questions, please give me a call at 521,-4956.
Si-ncerel Y,
Paul E. Fa r,
attachment
RAINBO OIL COMPANY
PUMP/DISPENSER CALIBRATION REPORT (5 GALLON TEST BUCKET)
/7 /F-<>, '714-*6 V7ooS.(bDateS.S.#Address
PUMP PRODUCT
DISPENSED
METER
BEFOBE
READINGS
AFTER
SHOFTAGE
cu. lN.
OVERAGE
cu. rN.
CORRECTED
cu. tN.
GALLONS
WITHDRAWN
5 fl.ot C7 fo oz c-'7fai 7 - 1f-z /c)
,G"/ol O tr:tt'/1 i C ,5''t6"\-.4.i- /- /o
5 lAtlL'l5+/)0 l{'4 / +o _Z '/(;,
6 rte q.Ot'szt:i:0 6:t)/J Z 'tr/ O
6 Golal 0:'t 6E5 o >'7c) ] 5 +t6 +-L.-t/Lt
6 [tl,,lL ,cq??aL o,;?rqciz 4 J(;
7 i4r ut,o8€'?79 ct ?€'t(s1 +L 4Q
7 Grl"/o, 7.e7/or?rc)/C 4C)
7 Lrn L,l6 773 C>I (,7c7 +)o -/ ()
I /te or ,o4zt4 tr Ctt+7/5(,+2 -/o
g G.IJ o 3015/() >thdri +L.-/O
I I4tlL,06r/ 76 036r V(A--4o
\
The undersigned parties certify that the above readings are true
and correct and the products drawn yrere returned to their
respective underground storage tanks
SIGNATURE OF
PREPARE IN DUPLICATE
Orlginal
Duplicate
-forward to General Office.
-Attach to daily report and forward
to General Olfice.
(-e\
[J.rA{- .
C"ee
?C
BO
qo
IOC JL
s1. t3
to-7. c3
MAINTENANCE MAN, SU OR CONTRACTOR &,; z{fi(
ZbC a?.J.88
t+l-
.-7
SHORf,AGE
.*.rcu. ttrt.
OVEBAGE
cu. tN.
CORBECTED
cu. lN.'r
ryilry
?.I J ''
! :r,:=
,-.?r1+ " &r r .9 .{ C
t !i*'
!'rr I ir.! l!T*U
P/DIS CAtl
RAINBO OIL CO MPANY
ONR EPORT (5 GALLON TEST BUCKET)
r-f\!_ltT;-rhtrtr BEf:iipT
! '.r 11 ,1 ,.,,1'1 i:rf : rlg : ?rl
f-- t t',., .rl f
^ i .; ,-,.,. r,-,
I r'l i ll:f'! .''.-
*.fr? r? ! 1 .r *I -',J ,:i--r.
i:l.lEl r:i!:ii": tj !.,?1:l
t?.':La 'rt.t
THF|!i': '''*l-1.
c',:rl'lE lltiflIN
FQ i f.rr41-1 :11! i]f] .
a., 1-t ,, .r-rl.-(i.f, f,(.r
.Lr'-: i L
".
r
trlEST LIftLLE'/,!-lfr]fi
Address
T
(
v
AFTER
!Weights & Measures
' ' 350 North Redwood Road
S.L.C., Utah 841 16
Phore [phone]
L{2tt Pum s tested for prod uct calibration
Ie3Water tests/Fuel s
Address City
Cou nty
Action Taken:
Stor tanks labeled
Fill ca and und round stor cove condition
Pu tested for mo calibration
Fuel filters on UM
Octane on m
PU ces le bldcorrecVcom lete
Securi seals intact
Station read-out matches
Road si rices correct (if
Cas taken
i
MOTOR FUET PRODUCTS USED FOR INSPECTION
aate h7a.u-? / ?9j
ti,--
Next'inspection due -- days
Purpose:Regular X
Reinspection
Complains
Unleaded Plus
-
Sallons
Diesel
-
Sallons
I
Est. l.D. #Name
I
o)F
o)!
E
zip
o
_o
'o
2
Product was returned to fuel storase tank.
lnspection Remark Vr*y 4";l /, l/rtLilJ Aza tl* uuf,* ar,,'rtwl
/c(t l--)
e
Received by
ame
lnspected by
UTAH .DEPARTMENT OF ACRICU LTU
-wEtcHTS & MEASURES DlVlSlON.i
CAS STATION INSPECTION REP.ORT
Regular-Z- gallons Unleaded Regular 9O gatlons
Unleaded Premium ?D gallons
o)
Uq)
il)E
4/'I . {r, ? r---?
rl 'r
RffII{Bd-TTMO.
3612 Ll, 4?CI11 S0'
tre3T USUUEV 'LlTtlH
5THTl0l,l +46
ILISTTII'IER PEFEIPI
915,'gr3rg3 14!!?i?B
trll+P, $ 6
5. r:]Er? rjffLz
Pr.rL 91.'tg? /
FLIEL sflLE
CH'cH'
RfrI4{B[-frIEtF,,
3612 td. 4?80 sB.
trrEsT t,ffLLE',f,,L!TBHi
A)tral
$4s.t"o
t:u5T0llEE I
Ll5,'Et3,'9S t
Rffil{Bo r}h,.
3612 ht, 4708 sff,
ttlEST UHLLEV ,UTfiH
CTISTII'IER HEf,EIPT
[tir€r3,r5;3 14: 1gs; 94
'[IISP, # I
5."808 "EffL
REE Fl.'I1?
FUEL SHIE
THfft*i ,/0Ll
c0HE flEfiItf
sTffTl0t,l s46
$5.60
40 Lral
$ar.ut
4D[ra I
$<4 zosrfittnx *+g
015P. l+ I
5.881 GHLz
Ltl.lL Lil . Eri]..l/
FUEL SIILE $5.{5
IiRSH t5:4E
$5, ?6
,\I-Ol D3' IlEl' ISOAU q--r; fi iffi,?O:iNFtr€IOt}sIiI
fufii,t-r,"r -: ii-.- Hlbi!:Un tgiht&S'rlf i,* ;!fu:.':tr i Io +:
It
i
Date
RAINBO OIL COMPANY
PUMP/DTSPENSER CALTBRATTON REPORT (5 GALLON TEST BUCKET)
7- l+ ?Z +6 +7,wS.S.#Address
PUMP PBODUCT
DISPENSED
METER
BEFORE
READI NGS
AFTER
SHORTAGE
cu. lN.
OVERAGE
cu. rN.
CORRECTED
cu. tN.
GALLONS
WITHDRAWN
5 y)l\ta.o6.flE6E o 6857 3 ,+i /c
5 &,/)0 ?q 771 c{+?zn/,l 1Dc az
.,
Ltte. I t nz o 1s
5 Ltll L,3+6 0q 3u7t1 ,!'_Z /o
/Rea-0E799 t 0 sts1 1 o /o
A Cn/.r/o3) 7 /7 oii3'73 -lo +L t5
/hnt.os7gD7 0e 7so7 +Z /C
7 R e^,onz56 07 ? z6i +L /o
7 /a6n 05 loo r 05 l0 /l -_L /o
7 hnt-.;*1oJ 1 l\otbVsl +1-/o
g R e*s, ,0z 8a td 02 8az6 -Z /6
4 ta/c,l 0-ztH+o3q 4zr +z t6
3 l/t n L,0tlrzz 07A7 3j 4 /o
The undersigned parties certify that the above-readings are true
and correct and the products drawn were ieturned to their
,. .:PBEPARE IN DUPLICATE
respective underground storage tanks
IL
U
corurnRcroBf,z(t
-f onrard tolbeneral Otf ice.
'
-Attach to daily report and forward
SIGNATURE
MAINTENANCE MAN, SU
qo - lt+I.b
,,.
:rr
OR
':;ii4-: '
M,t,.,*)'!i':-
,'*i' :-
-..,i,,,'ifi.
to General Office.
",
Name
Address
County
UTAH DEPARTMENT OF AGRICUL'I -..€
WEICHTS & MEASURES DIVISION
GAS STATION ]NSPECTION REPORT
Est.l.D.#
City
*"rgh. - Measures
350 North Redwood Road
S.L.C., Utah 841 16
Phone [phone]
oate TYla'{7l2,1177
due
-
days
Jrtesuct calibrationtested for
5Water testy'Fuel3'
L
l-
b
l/
b7L(JI I ELV LUI I I
L
,'0
zip
'ooo)
'o
o)
I
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0
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q)
rhq,
F
o-o
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z
3
Purpose:
Regular
Reinspection
Complaints
x
Action taken
filters bn
Octane
Pum ibl
seals intact
correct (if
taken '
Regular 4O gallons
Fill
tested
labeled
calibration
Un
to fuel tanks.
tank
u condition
on
*.
Road
Cas
,i
UnleadedRqular 40 gallons Unleaded Plus-gallons
premium l/O gallons Diesel gatlons
,t '- ti
Pr6dua was returned
Remarks:r
\\h4a
U"
Received by
I
I
I
by
,ff
RAINBO OIL COMPANY
PUMP/DTSPENSER CALTBRATTON REPORT (s GALLON TEST BUCKET)
Date S.S.#+A Address 4700 fo.3 {o0 w,
PUMP PRODUCT
DISPENSED
METER
BEFORE
READI NGS
AFTER
SHOBTAGE
cu. !N.
OVERAGE
cu. lN.
CORRECTED
cu. !N.
GALLONS
W!THDRAWN
I fr,"o 0183 / 7 d?9727 Uqe*a '4"b**;n cat79 /0
I R ve4 aTst z"z_o q2
=s-_z
ta /6
I C-,/a Aztsa(07 65ql TZ /o
/lAn/2 z s+sf zzv+ s0 +3 0 L5
Z h -.^.t z t97g tzts ? 3 +.,0 l5
2 &t/rl ogA=?l 60rw0q .*S _Z tg
2 04-ltL,2 474qo zQ790o bqd w +Z /o
l ftean.6q2qqfr os 2il3 "++
-A!'15
,},Crnlal o 6>ts3;063/d)*Z**$.' ./
J btn L, .:I g tqqo'l2 3e?5 -j.,'0 frr..f$#-'li''
o 6qo? #'o 6g 016 /o
06y'fr 067{50 /o
':,..*l rtrq o (/ ? +r0 t,' .+--*-. .
. ." t..*z
j
t-
i::.. .
I readingsaretrue''''l'l
retu'rned to their
PREPARE IN DUPLICATE
Orlglnal
Dupllcate
.n
-fonrard to General Office- .'.\,
-Attach to daily rcportrind.fonrard'' '
to General
I srGrun
t
.,i.,-: _f{
rl.l:!
- lii.W'
'i
t
MAINTENANCE MAN,
ry
,, :;:;ip':-;;17'O
*:,-
tii!
.i:!t'U- l,
:,!ii:
And and
;.!:tt;
1i'.'.. ij
fi: . si''
* .,,e'
I
_.1-
:,
,t: r, l i
.,]
RAINBO OIL COMPANY
PUMP/DTSPENSEB CALIBRATION REPORT (5 GALLON TEST BUCK ET)
4l--a
Date
tt
The undersigned pa rties certitythat the above readings arelruo
rnd correct products drawn were returned to thoir
Address 4too q. >da)l"r(
PBEPARE IN DUPLICATE
.v
S.S.+
-especlive u nd storage tanks
andithe
ndsrprou
..1;
Orlginal
Duplicate
-torward to General OfIic€.
-Attach to daily report and lorward
to General Offica,
MAINTENANCE
GALLONS
WITHDRAWN
SHOFTAGE
cu. lN.
OVERAGE
cu. lN.
COBRECTED
cu. tN.
METER
BEFORE
READINGS
AFTERPUMP
tzo lt /r r"t /)ut /'c/ /t=l't.+c:;4,\.r l:*tt 'i. tlq+9Rt--/oL -/-t L4?det't-+?rvR *.'a' .
1"1C//o//>1/6 / 6>.,6 /c?t3 ZZ t-3,3\ zzz zfh tt l-,
-t-3_/6/ flot tR nv,.15doo t
IJ /o/;4 +szzi2+r/".Irnllat-fL //)?-5 33fiE,4 ?l '2',)38Jl,(h t- .+7ro 6+7 7R.or,TZ ./apqoTZfoqo q tq6o1r,/
(1 /Oz 6 zo€4lt ut.+'L /o0€ 67 +{'1,'R..,66
o?086>oaor, >/oZil=&.t
,i'Ayt /,.Z6J>E
ri
ISOR, OR CONTRACTOR
I
I
I
PRODUCT
DISPENSED
1aI o6+67
Z6zoYY
/oIrf,il/,/
o
-
-.-
u.i,,Jl,.!J 16: i,i: :t_:l
frItP )'ol
N.
hBO
L CO.
,rr.:tzr/? 3
Ir-jggrvrPANY
l.FEPgFr (s caLLo N TF9T EVgKET)
Addrpss
I Er. Lr[
PHL E
F
CHBH
l.t
$l 1. ?E
B4r'itr?I lE: tlr 56-i-a--
04.'21 .,?S 14r51t[j
DISP
$ttJ.59
CB6H $ lr:t.
,,lqsjri tER
0
I
1
1 f6#,
n+;,it,':*: 16r 14:5E'
oisrl.?
(,r, O
)'o
'-/C
/'b
z4
1
Tax
TOTAL
1
$18, ul?
$tB' 819
!-79 C-005
d6
/Q.
I
I
Gel.
TI
{
>qt
SHOBTAGE.r'iu.itr. -OVEBAGE:,.cU.'itt.*OORFECTED-bulr,r,-: pal
W'TH
tz /o
.,+-L
I I
t
UTAH Sfr fAATi,tEi,iT iif
ENVIE0ri $,{ [: l,j?'A L fr ilAt"i iy
SEP 2 7 HrJ.f
_ plV" {ii i;i,lf iii{.1,i*r'i.:it:tL
R&i$f,'*irl$I Arui.l hiiltdf; *i,{TION
Septembet 22, 1993
Amoco Oil Company
Salt Lake City Business Unit
474 West 900 North
Salt Lake city, Utah 84103-1494
CERTIFIED MAIL
RETURN RECEIPT REOUESTED
Mr. William Moore
State of Utah
Division of Remediation and Response
Department of Environmental Ouality
1950 West North Temple
salt Lake city, Utah 84114-4840
Rainbo Service Station #46, 47OO South 3600 West, West Valley City, Utah
NOTICE OF INTENT TO REVOKE CERTIFICATE OF COMPLIANCE NO. 10821-3
Facilitv lD #4001576
Rainbo Oil Company is pleased to respond to your letter of August 13, 1993
(attached). lt is our understanding that based upon compliance review, the
subject station does not meet the following requirements of compliance, and is
therefor in violation of eligibility, and subject to certificate revocation.
No precision line tightness testing tor 1992, tanks #1, 2, and 3
No line leak detector testing for 1992, tanks #1, 2, and 3
No inventory control documentation
Please find attached precision line tightness testing, performed by Petro Tech in
September, 1992. Line leak detectors were also tested by Petro Tech
concurrently with the line testing.
The daily inventory record, together with the monthly reconciliation is provided for
the time period of January - December, 1992. lt should be noted that in January,
1993, Rainbo changed the its daily inventory control program to show sales
volume, and the calculated acceptable inventory deviation (sales X .Ol + 130
gallons). Should you desire to see the new record format (available from January
- August, 1993), they will be made available.
Based upon the submitted information, the subject station did have precision line
tightness testing and line leak detector testing (performed in 1992) together with
inventory control records. These records confirm that the requirements of
compliance have been fulfilled. The station is therefor not in violation of eligibility
requirements, and not subject to certificated revocation.
Mr. William Moore
September 22, 1993
Page 2
Should you have any questions. or if there is any further question concerning
compliance, please contact Mr. Paul E. Fairbanks immediately at (801 ) 521-4966.
l."t\ \.:J."-.-^-
Mark D. Dinterman. Manager
Environment, Health & Safety
Attachments
F. R. Sida
L. M. Pearson
P. E. Fairbanks
R4aNORg3.262
Michael O. Leavitt
G@ffi
Dianne R. Nielson, Ph.D.
Exertive Direaq
Kent P. Gray
Dire.te
DEPARTMENT OF EI\NTIRONMENTAL QUALITY
DIVISION OF ET.MRONMENTAL RESPONSE AND REMEDIATION
150 No(h 1950 West 2nd Floor
Salt [-ake City, Utah 84116
(801) 5364100
[phone] Fax
[phone]T.D.D.
ERRU-0465-93
CERTIFIED MAIL
RETT]RN RECEIPT REOI'ESTEI)
August 13, 1993
Paul Fairbanls
Amoco Oil Company dba Rainbo Oil Company
8156 South Highland Drive
Sandy, Utah 84093
RE:NOTICE OF INTENT TO REVOKE CERTIT'ICATE OF COMPLIANCE NO. 10821-3
Facility lD #4001576
Dear Mr. Fairbanls:
The Utah Underground Storage Tank Act (AcQ, Utah Code Ann. $ 19-6-414 provides that the
Executive Secretary UST may revoke a Certificate of Compliance if it is determined that a facility is not
in compliance with the requirements specified in Utah Code Ann. $$ 19-6412Q),413. The Act requires
substantial compliance with all state and federal statutes, rules and regulations including Utah Admin.
Code R31 l-202-L which incorporates by reference Code of Federal Regulations (40 C.F.R.) $ 280 in
effect as of May 26, 1992.
At the request of the Executive Secretary UST, the Division of Environmental Response and
Remediation DERR performed a compliance review for Certificate of Compliance No. 10821-3 issued
to a facility owned or operated by Amoco Oil Company, dba Rainbo Oil Company. This facility is
located at4700 South 3600 West, West Valley City, Utah. The designated facility identification number
is 4001576. This facility contains three underground storage tanks USTs.
The compliance review indicates you have not satisfied the requirements of compliance. As such,
you are violating the eligibility requirements for the Petroleum Storage Tank PST Fund and your
Certificate of Compliance may be revoked. To achieve compliance you must do the following:
Submit a copy of a precision line tightness and leak detector tests for tanks #1, #2 and
#3, performed in accordance with the requirements of the Act, for the tanks found in
non-compliance on May 17, 1993, as required by Utah Admin Code, R3l1-202-1. See
40 C.F.R. $ 280.41(a) (b), and 280.44.
Submit documentation that proper Inventory Control is completed on the following USTs
#1, #2 and #3, as required by Utah Admin. Code, R3Il-202-l and 40 C.F.R. $
280.43(a), by documenting you are now properly performing the following:
4b
I
,)
i.'.-l,r:,.-.i.ri.
Facility ID# 4001576
Page 2
Document that you meter the product and maintain the pumps to within a
calibration of accuracy of six cubic inches for every five gallons.
You have 60 days following the receipt of this letter to demonstrate compliance with the
requirements of the Act or your Certiflcate of Compliance will be revoked and you will be ineligible to
receive deliveries of fuel and receive payment for claims against the pST Fund.
If you fail to resolve the compliance problems described above within 60 days of receipt of this
letter, you will be notified by a Notice of Agency Action and Notice of Hearing. The purpose of the
hearing will be to determine if there is any reason your Certificate of Compliance should not be revoked.
Please contact William Moore at [phone] to discuss this notice at your earliest
convenience.
Sincerel v,
P
Gray,Secretary (UST)
Solid and Hazardous Waste Control Board
KPGAVMitnw
Fred Nelson, Attomey General's Office
John Inch Morgan, Acting Director, salt Lake city/county Health Departrnent
cc: