DERR-2024-010220

195 North 1950 West • Salt Lake City, UT
Mailing Address: P.O. Box 144840 • Salt Lake City, UT 84114-4840
Telephone [phone] • Fax [phone] • T.D.D. [phone]
www.deq.utah.gov
Printed on 100% recycled paper
State of Utah
SPENCER J. COX
Governor
DEIDRE HENDERSON
Lieutenant Governor
Department of
Environmental Quality
Kimberly D. Shelley
Executive Director
DIVISION OF ENVIRONMENTAL
RESPONSE AND REMEDIATION
Brent H. Everett
Director
ERRP-265-24
August 21, 2024
Chris Bartholomew
Timpanogos Regional Hospital
750 West 800 North
Orem, Utah 84057
Re:No Further Action for Piping Associated with Underground Storage Tank
Timpanogos Regional Hospital, located at 750 West 800 North, Orem, Utah
Facility Identification No. 1000999
Dear Mr. Bartholomew:
A review of the information submitted in the Closure Notice received on August 9, 2024,
for the above-referenced underground storage tank (UST), indicates that contaminant
concentrations are below State of Utah cleanup levels (Utah Admin. Code, R311-211-6). No
corrective action is currently required at this site for the regulated UST.
Corrective action may be needed in the future if contamination is found that exceeds State
of Utah cleanup levels.
If you have any questions regarding this matter, please contact Laura Perdue, the Division
of Environmental Response and Remediation project manager, at [phone].
Sincerely,
Brent H. Everett, Director
Division of Environmental Response and Remediation
BHE/LP/tt
cc: Eric Edwards, Executive Director, Utah County Health Department
Jason Garrett, Environmental Health Director, Utah County Health Department
LP8/15/2024
UNDERGROUND STORAGE TANK PERMANENT CLOSURE NOTICE (rev. 2/1/15) FACILITY ID# .... 10 ..... 0 ..... 09 .... 99 ____ _
State Use Only
Date Processed I by
Date Mailed to LIID
LUST ID#
Date to LUST Review
identified below b David Hansen
Phone# [phone]
StateUT Zi 84651
FACILITY INFORMATION
Tank Owner Mountain Star Medical Group I Phone# [phone]
Address 60 E South Temple Street, Suite 1900 I City Salt Lake City State UT I Zip 84111
Facility Name Timoanoi;i;os Rei;i;ional Hospital
Address 750 W 800 North I City Orem State UT I Zip 84057
Contact person Chris Bartholomew Phone# [phone]
Total number ofre!!lllated underground tanks at this site before closure 0
Total number ofre!!lllated underground tanks at this site after closure 0
TANKS CLOSED
Piping Only Tank#
[8J Please complete for each tank
Type (Steel,FRP,etc.)
Date Installed
Capacity (Gallons)
Substance stored*
Date last operated
Date Closed
Removed/In Place/ Change in
Service (CIS)?
*Indicate the specific substance stored in each tank to be closed (regular, unleaded, diesel, waste oil, etc.)
TANK REMOVER Name David Hansen I Cert. # TR0410 I Exp. Date 1/1/26
Company Rockwell Solutions, Inc. I Phone# [phone]
Address 718 E Brid2er Lane I City Elk Rid2e I State UT I Zip 84651
SOIL/GROUNDWATER SAMPLER Name Austin Merrell I Cert. # GS1945 I Exp. Date 5/9/26
Company CCI, Inc I Phone# [phone]
Address 1876 N 2700 West, Suite 5 I City Provo I State UT I Zip 84601
CLOSURE INFORMATION
Fuel was emptied D I Sludge was removed D I Tank was cleaned D
Tank was: I Purged D I Inerted D I Method Used:
Location of Closure Records: CCI, Inc office
For In-Place Closure: tanks filled with:
For Change-In-Service: Substance to be stored:
1
DISPOSAL SITES USED
Location Name Contact Name Phone# Date Amount
Tank(s) NA Tank#
Product From Tank(s)
Contaminated Water
From Tank Cleaning
Sludge
Contaminated Water
From Excavation
Contaminated Soil
SITE ASSESSMENT
Complete 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 samples must be consistently identified by sample ID #
on the site plat, table, and lab analysis report .
[8J Completed Facility Site Plat (Closure Notice) is attached.
The following must be included (enter the distance, and direction (N,S,E,W) from the area of contamination or, where applicable,
use OH for overhead, NP for not present):
60 E Water Line > I 00 Sewer Line 40 SE Natural Gas NP Storm Drain NP Telephone > I 00 Electrical 70 E Property Line 12 W Buildings
[8J Completed Sample Information Table (Closure Notice) is attached.
[8J Certified lab analytical environmental sample results are attached.
[8J Unified Soil Classification (USC) sample results are attached.
[8JChain of Custody form is attached.
Samples were properly: [8J Collected [8J Labeled [8J Packaged [8J Transported
[8J Samples were in sight of the person in custody at all times or in a secured locked place.
I certify under penalty of law that the closure site assessment at this facility was conducted in accordance with 40 CFR 280.52, 40
CFR 280.72, and R311-205 U.A.C., and that any additional samples required by 40 CFR 280.52, 40 CFR 280.72 and R311-205-2(a)(l)
were properly collected.
Signature of Certified Groundwater/Soil Sampler
Full name of Certified Sampler Austin Merrell I Date 7 /31/24
If contamination at the facility is confirmed, any person providing remedial assistance for a fee must be a Certified UST Consultant. The
Certified UST Consultant providing assistance is:
CERTIFIED UST CONSULTANT
Name David Hansen I Cert. #CC 0130 I Exp . Date 1/1/2026
Company Rockwell Solutions, Inc I Address 718 E Bridger Lane
City Elk Rid2e I State UT I Zip 84651 I Phone# [phone]
Please explain any unusual circumstances that occurred during the site assessment or closure:
2
Facility Site Plat (Closure Notice)
The site plat must be drawn to an appropriate identified scale. It must show planned sampling locations, substances stored in tanks, and
other relevant information. Tank and sample identification numbers must be consistent with the information given on p. 1 and 4 of the
Closure Notice.
See Figure 1 (attached)
I Facility ID: I DrawnBy:
X = Sample locations (SS-#, WS-#, USC-#)
0 = Monitoring Wells (MW-#)
D = Soil boring (SB-#), or Geoprobe Boring (GP-#)
• = Water Wells (domestic, livestock, etc.)
Slope of Surface Topography: (N,NW,W,SW,S,SE,E,NE)
Land Use At Site: _Residential _Commercial _Industrial
Surrounding Land: _Residential _Commercial _Industrial
North
~ Scale: 1"= Feet
I Date:
Site Plat Must Indicate Actual Locations Of:
✓ 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.)
✓ Depth to groundwater (if encountered)
✓ Excavations, GW monitoring wells & soil stockpiles
3
SAMPLE INFORMATION TABLE (Closure Notice)
Complete table for all samples that were taken for closure. Sample ID numbers on the table must be consistent with the sample ID
numbers given on the site plat and in the lab analysis report.
Sample Substance Sample Depth2
# stored in tank type 1
Timpano diesel ss 2
Timp same USC 2
I Soil (SS), Groundwater (GW), or Unified Soil Classification (USC).
2 Final depth (in feet) below grade at which samples were tak en.
3 C'ontammant compound(s) analyzed for each sample (TPH , BTEXN. O&G. etc).
4 Appropriate analysis methods for contaminant compound(s) in each sample
State Certified Laboratory used Chemtech Ford Laboratory
Address 9632 South 500 W est
Compounds 3 Analysis method(s)4
BTEXN, TPH-DRO 8260,8015
Uniform Soil Classification D2487
J City Sandy I State UT I Zip 84070
Contact Person Reed Hendricks / Phone# [phone]
I certify under penalty of law that I am the Owner of the tank(s) described above and that I am familiar with the infonnation on this form
and that it is true, accurate and complete and further, that the procedures described herein were followed during tank closure.
Si nature of UST owner
Full Name of owner
Return completed Closure Notice form , Facility Site Plat and Sample Information Table, Soil/Groundwater sample lab analysis results,
USC sample results, and Chain of Custody form within 90 days of UST Closure to:
Mailing Address
State of Utah Dept. of Environmental Quality
DERR I UST Section
P.O. Box 144840
Salt Lake City, Utah 84114-4840
Street Address
Multi Agency State Office Building
195 North 1950 West (First Floor)
Salt Lake City, Utah 84116
4
•• Sample Location
------Water
Gas
.,, : j: 11!.l L .
1
~ i-
1mpanogos Hospital ~ • 750 W 800 North ? Orem,Utah 00 20
Approx. scale in feet
Figure 1 I Piping Closure Map
9632 South 500 West
I
CH EMTECH1 'FORD
I.OO !R i\TO ~I-S
7/19/2024
Work Order: 24G0657
Project: Timpanogos Hospital
Attn: CCI, Inc.
1876 N 2700 W Bldg #5
Provo, UT. 84601
Client Service Contact: 801.262.7299
The analyses presented on this report were performed in accordance with the
National Environmental Laboratory Accreditation Program (NELAP) unless
noted in the comments, flags, or case narrative . If the report is to be used for
regulatory compliance, it should be presented in its entirety , and not be
altered .
Approved By:
Reed Hendricks, Lab Director
Sandy, Utah 84070 801 .262 .7299 Main 866 .792 .0093 Fax
Serving the lntermountain West since 1953
www.ChemtechFord.com
Page 1 of 5
Chemtech-Ford Laboratories
9632 South 500 West
Sandy, UT 84070
0 :[phone] F: [phone]
www.ChemtechFord.com
CHEM TECH ·FORD Serving the lntermountain West Since 1953
l lo 601tATOfHES
CCl,lnc.
1876 N 2700 W Bldg #5
Provo, UT. 84601
Certificate of Analysis
PO#:
Receipt: 7/9/24 13:25@ 7.2 ·c
Date Reported: 7/19/2024
Project Name : Timpanogos Hospital
Sample ID : Timpanogos Hospital Below AST Product Lines
Matrix: Solid
Date Sampled : 7/9/24 7:35
Inorganic
United Soil Classification [USC]
Project Name : Timpanogos Hospital
www.ChemtechFord.com
Result Units
SC
Minimum
Reporting
Limit
Sampled By : Austin Merrell
Method
ASTM D2487-Mod
CtF WO#: 24G0657
Preparation
Date/Time
7/15/24
Lab ID : 24G0657-01
Analysis
Date/Time
7/15/24
Page 2 of 5
Chemtech-Ford Laboratories
9632 South 500 West
Sandy, UT 84070
0 :[phone] F: [phone]
www.ChemtechFord.com
CHEM TECH ·FORD Serving the lntermountain West Since 1953
l lo 601tATOfHES
CCl,lnc.
1876 N 2700 W Bldg #5
Provo, UT. 84601
Sample ID : Timpanogos Hospital
Matrix: Solid
Date Sampled : 7/9/24 11:35
Inorganic
Total Solids
iesel Range
Diesel Range Organics
olatile Organic Compounds
Benzene
Ethylbenzene
Naphthalene
Toluene
Xylenes, total
Project Name : Timpanogos Hospital
www.ChemtechFord.com
Result
92 .5
ND
ND
ND
ND
ND
ND
Certificate of Analysis
Units
%
mg/kg dry
mg/kg dry
mg/kg dry
mg/kg dry
mg/kg dry
mg/kg dry
Minimum
Reporting
Limit
0.1
54
0 .01
0.03
0.03
0 .03
0.08
PO#:
Receipt: 7/9/24 13:25@ 7.2 ·c
Date Reported: 7/19/2024
Project Name : Timpanogos Hospital
Sampled By : Austin Merrell
Method
CTF8000
EPA8015 C
EPA 8260D/5030B
EPA 8260D/5030B
EPA 8260D/5030B
EPA 8260D/5030B
EPA 8260D/5030B
CtF WO#: 24G0657
Preparation
Date/Time
7/11/24
7/17/24
7/15/24
7/15/24
7/15/24
7/15/24
7/1 5/24
Lab ID : 24G0657-02
Analysis
Date/Time
7/11/24
7/17/24
7/15/24
7/15/24
7/15/24
7/15/24
7/15/24
Page 3 of 5
CHE MTECH ·FORD
l lo 601tATOfHES
Chemtech-Ford Laboratories
Serving the lntermountain West Since 1953
9632 South 500 West
Sandy, UT 84070
0 :[phone] F: [phone]
www.ChemtechFord.com
CCl,lnc.
1876 N 2700 W Bldg #5
Provo, UT. 84601
Report Footnotes
Abbreviations
Certificate of Analysis
PO#:
Receipt: 7/9/24 13:25@ 7.2 ·c
Date Reported: 7/19/2024
Project Name: Timpanogos Hospital
ND= Not detected at the corresponding Minimum Reporting Limit (MRL).
I mg/L = one milligram per liter or I mg/kg = one milligram per kilogram = I part per million.
I ug/L = one microgram per liter or I ug/kg = one microgram per kilogram = I part per billion.
I ng/L = one nanogram per liter or I ng/kg = one nanogram per kilogram = I part per trillion.
On calculated parameters, there may be a slight difference between summing the rounded values shown on the report
vs the unrounded values used in the calculation.
Project Name : Timpanogos Hospital
www.ChemtechFord.com
CtF WO#: 24G0657
Page 4 of 5
CHAIN OF CUSTODY -SAMPLE SUBMITTAL FORM
COMPANY:
ADDRESS :
CITY/STATE/ZIP:
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Sample co ndition
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1 Contai ner Intact :..I. Sufficient Sa m ple Vo lume Delivery M ethod
COC/La bels Agree Hea dspace Prese nt (V OC ) UPS USPS
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QC levels d efinition : QC1 : none QC2 : Batch QC, ra nd om
sa mple
1-------, ,-,-.,.-d,-.,,-d-.,-m-0-,,,.,-n-d-,u-bj-.,-"-------lo c J : 25% surcharge . Narrative plus Batch QC, your sample
to additional ch arg~ se lected
QC4 : 40 % surc harge . Add raw data
TESTS REQUESTED
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UJ ~ Lab Use Only "2--4 Gi O LR 5"7 CLIENT SAMPLE INFORMATION j.-
L A BORAT O RIES
Chemtech-Ford Labo ratories
9632 South 500 West
San dy, UT 84070
Ph one: 801-262-7299
www.chemtech ford.com
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Special Instructions: Samples received outside the EPA recommended
,..,_A_,-,rr-temperature range of 0-6 C0 may be rejected. -
Relin~uished b .7.,;; Da t e/Time --1 -'
Rec•nnt;,";)~ J1 f prJa ~ Oate/nme --t -Ci -2.-C..C 7.q.7,tf e!, /3~S:--
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Re linqu ished by: (signature) V ' (J Oat e/nme Reiteiv ed y: (signatu re] . ba6/'rirTl e -
Payment Terms are net 30 days OAC. 1.5% interes t charge per month (18% per annum). Client ogress to pay collection costs and attorney 's fees. Page 5 of 5