DERR-2024-010176

Utah DEQ Underground Storage Tank
Installation Notification Form
www.undergroundtanks.utah.gov
Facility ID New UST Install [ ] Upgrade/Repair [ ]
Installation Company:
Contact Name: Phone:
Address:
Tank Owner:
Address:
Contact Name: Phone#
Facility Name:
Facility Address:
Installation / Upgrade /Repair Information Est. Date work will commence:
Tank #
Capacity
Tank Material
Piping Material
Substance stored
Check if upgrade or repair only. (Describe details below)
Describe Details of Install/Upgrade/Repair in the box below (Submit a drawing/site map of work to be done)
Mail completed form to:
DEQ/DERR
Box 144840
Salt Lake City, Utah 84114-4840
195 N. 1950 W. 1st Floor
Salt Lake City, Utah
Phone [phone]
Fax [phone]
Ver. 8/1/2016
State Use Only
Permit Required?
Permit # _____________________
Base Fee $ __500
Inspection Fee* $200 x ___ $_ ___
PST Install Fee $200 x ___ $_ ___
Total $__ ___
Date Approved & Paid ___________
*Applies in non-LHD contract areas
Certified Installers/Technicians on project
Name Cert. # TL Exp. Date
Name Cert. # TL Exp. Date
Name Cert. # TL Exp. Date
1
Jackson Energy Cottonwood Heights, UT - UST Lining
www.cgrs.com
800.288.2657
1301 Academy Ct.
Fort Collins, CO 80524
June 27, 2024
Ernie Vasquez Via Email: Ernie,[e-mail]
Jackson Energy - Chevron
7006 S. 2000 E.,
Cottonwood Heights, UT 84121
Re: Proposal for three (3) UST 12,000-gallon Repair & Lining
Dear Mr. Vasquez:
CGRS appreciates the opportunity to submit this proposal for evaluating, repairing, and lining three (3) underground
storage tanks (UST) located at 7006 S. 2000 E., Cottonwood Heights, UT 84121 . The process will include cutting
new access way into the USTs, clean out, abrasion blast, perform structural analysis, line the USTs per API 1631
and install new manway access lids (sump and traffic ring install provided by other contractor). The current USTs
are fiberglass double-walled 12,000-gallon tanks. The owner will provide an excavation and paving company to
construct 6-foot by 6-foot access ways to each tank, per instructions from CGRS.
Scope of Work
Prior to the start of the project, the USTs shall be empty of fuel, or as low as possible, one tank shall be made
available prior to the start of the project. CGRS shall coordinate with the Utah DEQ on the installation and obtain
all permits. CGRS shall provide all equipment, materials, and labor to perform three (3) internal API 1631 tank
lining on existing 12,000-gallon USTs. The following outlines the scope of work:
▪Prepare health and safety and work plans, procure materials, schedule tasks, and coordinate with the
regulators.
▪Mobilization—Mob to site. Purchase equipment, epoxy to be billed at 50 percent of the project total prior to
mobilization. If a tank cannot be lined a credit for materials shall be issued.
▪CGRS will de-gas the UST with a forced air venturi dispersing vapors . Once the LEL (lower explosive limit) is
down to zero (0) CGRS shall cut into the UST. Each tank is anticipated to take 4-days to complete. CGRS shall
inspect the shoring to ensure proper installation in the excavation.
▪CGRS shall vent UST. CGRS shall prepare the tank for confined space entry and clean the tank. CGRS will
use a 4-gas air monitor to observe the tanks’ conditions every time a confined space certified employee is
going to enter the tank and every 60 minutes as well. CGRS crew members retain certifications in 40
Hazwoper, Confined Space, Ultrasonic Testing, and ICC. A three to four-man crew on-site at all times
because we are trained and have the proper equipment to complete a safe retrieval of a crew member if the
confined space entrant was to sustain an injury or become unconscious. Any remining petroleum waste shall
be drummed for disposal by owner.
▪The tank shall be abrasion blasted and the blast material removed. CGRS’s engineer shall evaluate the tank
structurally and ensure the UST is fit for repairs. The tank shall be repaired with boiler plugs and fiberglass.
▪The tank shall be fully epoxy lined with a fuel compatible liner from Enviroline. After the tank has dried for 12
to 18 hours, CGRS shall enter the tank to measure liner thickness and cover any coating holidays.
▪CGRS shall inspect work quality after completion and install bolt on man-way lids for future access. Any work
2
www.cgrs.com
800.288.2657
1301 Academy Ct.
Fort Collins, CO 80524
Jackson Energy Cottonwood Heights, UT - UST Lining
quality issues shall be corrected prior to calling for inspection by UT DEQ.
▪CGRS shall prepare a report summarizing findings, structural analysis , documenting finished work product and
provide a 1-year warranty for the UST’s liner.
▪Coordinate with client for punch list items.