DERR-2024-010382

APPLIED ENVIRONMENTAL SERVICES, L.C.
PO BOX 1073 BOUNTIFUL, UTAH 84011 801-540-9258
TEI 5000 NON VOLUMETRIC, TEI 4000 VOLUMETRIC, TEI ULLAGE, TEI LT3
PRECISION TANK & LINE TEST RESULTS SUMMARY
INVOICE ADDRESS:TANK LOCATION: WORK ORDER #
TECH # 94027
TECHNICIAN: SM
STATE TECH #
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
GRANITE EDUCATION CENTER
2500 SOUTH MAIN
SALT LAKE CITY, UTAH 84115
24086
UT 0121
DATE:
8-21-2024
TIME START:
11:00
TIME END:
16:00
GROUNDWATER DEPTH:
N/A DW TKS
TANK TANK
CAPACITY
11527
11527
PRODUCT
DSL
DSL
TANK
PASS
PASS
VENT
PASS
PASS
PRODUCT
LINE
PASS
PASS
LINE LEAK
DETECTOR
NONE
N/A
WATER IN
TANK
0.0"
0.0"
PUMP
TYPE
PRESS
SUCTION
TANK
MATERIAL
DWF
DWF
1.
2.
3.
4.
5.
6.
PRODUCT LINES TESTED AT 50 PSI FOR 15 MIN
LINE RATES (GPH)
1.
2.
3.
5.
6.
DSL -.010
ADDITIONAL INFORMATION:TK1 GOES TO BOILER, TK2 GOES TO GENERATOR
SUCTION LINE FOR GENERATOR TESTED WITH TANK.
CERTIFIED TECHNICIAN SIGNATURE:DATE:8-21-2024
These systems meet all requirements set forth by USEPA 40 CFR and has received third party certification.
4.
TEST METHODS USED FOR THIS LOCATION
TEI 5000 NON VOLUMETRIC TANK TEST TEI 4000 VOLUMETRIC TANK TEST TEI TANK ULLAGE TEST TEI LT3 LINE TESTX X
LINE LEAK DETECTOR TYPE & SIMULATED LEAK RATE
1.
2.
3.
M = MECHANICAL E = ELECTRONIC # = (GPH) RATE
4.
5.
6.
All tests were performed according to manufacturer protocol, and within the common practices of the industry. However due to the variables of
tightness testing, these results cannot be guaranteed. There are no warranties expressed, written or implied.
DEQ ID#4001977
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.08.24 14:39:44 -07'00'
Reason: I am the author of this document
UST OVERFILL EQUIPMENT INSPECTION
AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE
Facility Name:
Address:
City, State, Zip Code:
Facility I.D. #
Testing Company:
This data sheet is for inspecting automatic shutoff devices and ball float valves. See PEI/RP 1200, Section 7 for inspection procedures.
Owner:
Address:
City, State, Zip Code:
Phone#
Tester Phone#
Product Grade:
Tank Number:
Tank Volume, gallons:
Tank Diameter, inches:
Overfill Prevention Device Brand:
Overfill Type
AUTOMATIC SHUTOFF DEVICE INSPECTION
1. Drop tube removed from tank?
2. Drop tube and float mechanisms
are free of debris?
3. Float moves freely without
binding and poppet moves into
flow path?
4. Bypass valve in the drop
tube is open and free of
blockage (if present)?
5. Flapper is adjusted to shut off
flow at 95% ?*
A "NO" to any item in Lines 1-5 indicates a test failure.
BALL FLOAT VALVE INSPECTION * *
1. Tank top fittings are
vapor-tight and leak free?
2. Ball float cage free of debris?
3. Ball free of holes and cracks
and moves freely in cage?
4. Vent hole in pipe open and
near top of tank?
5. Ball float pipe is proper length
to restrict flow at 90% capacity?***
A "NO" to any item in Lines 1-5 indicates a test failure.
Test Results:
* Use manufacturer's suggested proceedure for determining if automatic shutoff device will shut off flow at 95% capacity.
Tester's Name:
GRANITE EDUCATION
2500 SOUTH MAIN
SALT LAKE CITY, UTAH
4001977
AES UTAH LICENCE # UT 0121
STATE FUEL NETWORK
PO BOX 841152
SALT LAKE CITY, UTAH 84141-1152
BRETT GURNEY 385-602-4872
801-540-9258
Date: 8-21-2024
DSL
1
11527
90
OPW 71SO
AUTOMATIC
YES
YES
YES
YES
DSL
2
11527
90
OPW71SO
AUTOMATIC
YES
YES
YES
YES
Steven B. Martin Testers Signature:
* * If a ball float is found to fail the inspection , another method of overfill must be used.
* * * Use manufacturer's suggested procedure for determining if flow restriction device will restrict flow at 90% capacity.
Comments
PASS PASS
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.08.24 16:44:20 -07'00'
Reason: I am the author of this document
GRANITE EDUCATION BUILDING
2500 SOUTH MAIN
SALT LAKE CITY, UTAH
4001977
APPLIED ENVIRONMENTAL SERVICES
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
BRETT GURNEY 385-6-2-4872
801-540-9258 8-21-2024
STP SU
DSL
X
X
X
X
X
X
X
X
PIP SU
DSL
X
X
X
X
X
X
X
X
SENSORS TRIGGER AUDIBLE AND VISUAL ALARM
STEVEN B MARTIN
APPLIED ENVIRONMENTAL SERVICES, L.C. PO BOX 1073 BOUNTIFUL, UTAH 84011
801-540-9258 [e-mail]
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.08.24 14:41:23 -07'00'
Reason: I am the author of this document
SPILL PREVENTION TEST
Spill Bucket Hydrostatic Test Form
Facility Name Facility ID
Address Tester's Name
Test Date Phone
Tank Number
Product Stored
Capacity
Manufacturer
Construction
Liquid and Debris
Removed
Visual Inspection
No cracks, holes,
or separations
Tank Riser Cap
Included in Test
Is Drain Valve
Included in Test
Start Level
Start Time
Ending Level
End Time
Test Period
(minimum of 1 hour)
Change in Level
Test Results
Photos indicating water
Levels are Attached?
Pass / Fail Criteria: Must pass visual inspection, test duration at least one hour, must include photos with this
form, water level drop of less than 1/8 inch. Ref: PEI / RP 1200 6.2.5 Test Procedure
How was Liquid Disposed?
Comments
I certify under penalty of law that the above information is true, accurate and complete
Tester's Signature
GRANITE EDUCATION 4001977
2500 SOUTH MAIN
SALT LAKE CITY, UTAH
STEVEN MARTIN AES TESTING
8-21-2024 801-540-9258
1
DSL
5
EBW
DW
YES
PASS
NO
YES
13 1/2
12:45
13 1/2
13:45
1 HR
0
PASS
NO
2
DSL
5
EBW
DW
YES
PASS
NO
YES
13 7/8
12:45
13 7/8
13:45
1 HR
0
PASS
NO
REUSED
UTAH TESTER UT 0121
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.08.24 16:42:27 -07'00'
Reason: I am the author of this document
AUTOMATIC TANK GAUGE OPERATION INSPECTION
Facility Name:
Address:
City, State, Zip Code:
Facility I.D. #
Testing Company:
Owner:
Address:
City, State, Zip Code:
Phone #
Testers Phone #
Date:
This procedure is to determine whether the ( ATG) is operating properly. See PEI/RP1200 Section 8.2 for the proper inspection procedure.
Tank Number
Product Stored:
ATG Brand and Model
1. Tank Volume, gallons
2. Tank Diameter, inches
3. After removing the ATG from the tank, has it
been inspected and any damaged or missing
parts replaced?
4. Float moves freely on the stem without
5. Fuel float level agrees with the
value programmed into the console?
6. Water float level agrees with the value
programmed into the console?
7. Inch level from bottom of stem when 90%
alarm is triggered.
8. Inch level at which the overfill alarm
activates corresponds with value programmed
in the gauge?
9. Inch level from the bottom when the water
float first triggers an alarm.
10. Inch level at which the float alarm activates
corresponds with value programmed in the
gauge?
If any answers in Lines 3,4,5, or 6 are "NO" the system has failed the test.
TEST RESULTS
Comments:
Testers Name: Steven B. Martin Testers Signature:
GRANITE EDUCATION BUILDING
2500 SOUTH MAIN
SALT LAKE CITY, UTAH
4001977
AES UTAH TESTER # UT 0121
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
BRETT GURNEY 385-602-4872
801-540-9258
8-21-2024
1
DSL
TLS 300C
11527
92
YES
YES
YES
YES
76
YES
2.0
YES
2
DSL
TLS 300C
11527
92
YES
YES
YES
YES
76
YES
2.0
YES
PASS PASS
BATTERY BACKUP FUNCTIONS PROPERLY
BOTH SUMP SENSORS FUNCTION PROPERLY, SENSORS TRIP AUDIBLE AND VISUAL ALARM
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.08.24 16:45:53 -07'00'
Reason: I am the author of this document