DERR-2024-010324

Page 1 of_Utah Department of Environmental Quality
APST Equipment Verification lnspection
6000061
Ownership of Tanks Location of Tanks
HIGH COUNTRY FUELS EAGLES LANDING FLYING J
P O BOX 911837 653 W 1400 N
SAINT GEORGE UT 84791 BEAVER UT 84713
Contact Name:#/Email:
SPCC Plan?: Yes No Last Fire Marshal lnsp:ATG lnfo:
Complete for each tank.#l)#<'# ir ###
Capacity of tank (gallons):2 alZ -->
Orientation of tank:H ,O r r'r- ',+ol___---:,
Bottom of tank in contact with (soil,
gravel, concrete, not touching):AlvZ Jo ',r" h,t ^3--->
Substance stored:I
Date last used/depth of product:
Type of spill prevention device:Y)rt L on,4.z /-L
Type of Piping (Pressure or Suction):P re-/41 u kt-\
Does pressure piping have LLD:Yes @ Nn Yes @ run Yes NA@ Yes No NA Yes No NA Yes No NA
Spill bucket is clean, intact, etc.Yes No Yes No Yes No Yes No Yes No Yes No
Type of overfill Prevention device:
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified:Yes No NA
Pipe trans flex protection method
(Sump, CP, lsolated, Booted):
Containment sumps dry:Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Sump comments:
Stage 1 Vapor Recovery:2pt Coax None 2pt Coax None 2pt Coax None 2pt Coax None 2pt Coax None 2pt Coax None
Pressure Vent Valve is on vents:Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Secondary containment area
comments:
Complete for each dispenser * 2a/ za *3t/az #
Flex protection method (UDC,
Cathodic Protection, lsolated, Booted):il 0r--
UDC sump dry:No NA 6@ ruo NA @ruo NA No NA No NA Yes No NA
Fire valve anchored, located below
grade, and without ball valve:@ No NA I No NA No NA@ @NoNA No NA{,Yes No NA
Comments:
Additional dispenser questions ######
Flex protection method (UDC,
Cathodic Protection, lsolated, Booted):
UDC sump dry:Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored, located below
grade, and no ball valve:
Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Comments:
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Financial Responsibility (State Use Only)
p1-fFR Method Method OK?d"9 ruo oy: Zf) V
Signatures
Srrn n lrle fy,1 Ci."^9/zzhlnspected this facility
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O/O Signatu?e:
Attach Tank lnfo Sheet to lnspection with any edits.
Additional Comments:
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Page 2 of _Utah Department of Environmental Quality
APST Site Plat
6000061
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(A), interstitial probe (l), vapor recovery (V), capped plug (C), other
locations of all buildings, streets, tanks,
and identify each: submersible pump
lndicate the product in each tank. Show locations of tank
Comments:
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