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HomeMy WebLinkAboutDERR-2024-0105411 UNDERGROUND STORAGE TANK PERMANENT CLOSURE NOTICE (rev. 2/1/15) FACILITY ID# . … State Use Only Date Processed by Date Mailed to LHD LUST ID# Date to LUST Review Closure Notice prepared at the request of the owner/operator (identified below) by of (company name) Phone # Address City State Zip TANKS CLOSED Piping Only Tank # 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.) CLOSURE INFORMATION Fuel was emptied Sludge was removed Tank was cleaned Tank was: Purged Inerted Method Used: Location of Closure Records: For In-Place Closure: tanks filled with: For Change-In-Service: Substance to be stored: FACILITY INFORMATION Tank Owner Phone # Address City State Zip Facility Name Address City State Zip Contact person Phone # Total number of regulated underground tanks at this site before closure Total number of regulated underground tanks at this site after closure TANK REMOVER Name Cert. # TR Exp. Date Company Phone # Address City State Zip SOIL/GROUNDWATER SAMPLER Name Cert. # GS Exp. Date Company Phone # Address City State Zip Aaron Spackman Spackman Enterprises 801-598-7928 Po BOX 1276 Centerville UT 84014 State Fuel Network 385-602-4872 4315 S 2700 W Taylorsville UT 84129 Aaron Spackman 0436 04/15/25 Spackman Enterprises 801-598-7928 Po BOX 1276 Centerville UT 84014 Troy Spackman 0432 05/01/26 Spackman Enterprises 801-598-7928 Po BOX 1276 Centerville UT 84014 1200325 Weber County Roads Department EDEN 4753 E 2650 N Eden Ut 84310 Brett Gurney 385-602-4872 2 0 1 Steel DW FLEX 6000 Gas 06/17/24 06/25/24 Removed 2 Steel DW FLEX 8000 Dsl 06/17/24 06/25/24 Removed Dry Ice DERR 2 DISPOSAL SITES USED Location Name Contact Name Phone # Date Amount Tank(s) 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. 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): Water Line Sewer Line Natural Gas Storm Drain Telephone Electrical Property Line Buildings Completed Sample Information Table (Closure Notice) is attached. Certified lab analytical environmental sample results are attached. Unified Soil Classification (USC) sample results are attached. Chain of Custody form is attached. Samples were properly: Collected Labeled Packaged Transported 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)(1) were properly collected. Signature of Certified Groundwater/Soil Sampler Full name of Certified Sampler Date 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 Cert. #CC Exp. Date Company Address City State Zip Phone # Please explain any unusual circumstances that occurred during the site assessment or closure: Sump and Trap Cleaning Shane 801-595-8151 Same Same Metro Group Inc Scale 801-383-0861 06/25/24 2 06/24/24 159 NP NP NP NP NP NP NP NP Troy D. Spackman 08/23/24 3 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. Facility ID: Drawn By: Date: X = Sample locations (SS-#, WS-#, USC-#) Site Plat Must Indicate Actual Locations Of: 0 = Monitoring Wells (MW-#) √Current & former tanks, piping & dispensers = Soil boring (SB-#), or Geoprobe Boring (GP-#) √ Location of all samples to be taken ●= Water Wells (domestic, livestock, etc.)√ Buildings, fences, & property boundaries Slope of Surface Topography: (N,NW,W,SW,S,SE,E,NE)√ Utility conduits (sewers, gas, water, storm drains, electrical, etc.) Land Use At Site: Residential Commercial Industrial √ Depth to groundwater (if encountered) Surrounding Land: Residential Commercial Industrial √Excavations, GW monitoring wells & soil stockpiles North Scale: 1”= Feet 1200325 Troy Spackman 06/17/24 4 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. 1 Soil (SS), Groundwater (GW), or Unified Soil Classification (USC).2 Final depth (in feet) below grade at which samples were taken.3 Contaminant 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 Address City State Zip Contact Person 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 information on this form and that it is true, accurate and complete and further, that the procedures described herein were followed during tank closure. Signature of UST owner Full Name of owner Date 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 / UST Section P.O. Box 144840 Salt Lake City, Utah 84114-4840 Sample # Substance stored in tank Sample type1 Depth2 Compounds3 Analysis method(s)4 Street Address Multi Agency State Office Building 195 North 1950 West (First Floor) Salt Lake City, Utah 84116 Chemtech Ford 9632 S 500 W Sandy UT 84070 Office 801-262-7299 SS-1 SoilGAS/DSL 12'MBTEXN TPH DRO GRO 8015,8260 SS-2 GAS/DSL Soil 12'MBTEXN TPH DRO GRO 8015,8260 SS-3 GAS/DSL Soil 12'MBTEXN TPH DRO GRO 8015,8260 SS-4 GAS/DSL Soil 12'MBTEXN TPH DRO GRO 8015,8260 SS-5 GAS/DSL Soil 12'MBTEXN TPH DRO GRO 8015,8260 USC-1 USC USC 12'USC USC USC-2 USC USC 3'USC USC Brett Gurney (Aug 26, 2024 07:13 MDT) Brett Gurney 08/26/2024 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. Client Service Contact: 801.262.7299 Spackman Enterprises, L.C. Attn: Troy Spackman PO Box 1276 Centerville, UT 84014-5276 Work Order: 24F2063 Project: Weber County Eden 6/27/2024 Approved By: Mark Broadhead, Project Manager 9632 South 500 West Sandy, Utah 84070 Serving the Intermountain West since 1953 801.262.7299 Main 866.792.0093 Fax www.ChemtechFord.com Page 1 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: SS-1 @ 12' Lab ID: 24F2063-01Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:25 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic %6/26/246/25/240.1 CTF800095.1Total Solids MBTEXn mg/kg dry 6/25/246/25/240.10 EPA 8260D/5030BNDBenzene mg/kg dry 6/25/246/25/240.25 EPA 8260D/5030BNDEthylbenzene mg/kg dry 6/25/246/25/240.15 EPA 8260D/5030BNDMethyl tert-Butyl Ether (MTBE) mg/kg dry 6/25/246/25/240.25 EPA 8260D/5030BNDNaphthalene mg/kg dry 6/25/246/25/240.25 EPA 8260D/5030BNDToluene mg/kg dry 6/25/246/25/240.75 EPA 8260D/5030BNDXylenes, total Gasoline Range mg/kg dry 6/25/246/25/242.50 EPA 8260B/C 5035A/[CALC]NDGasoline Range Organics Diesel Range mg/kg dry 6/26/246/25/2450EPA 8015 CNDDiesel Range Organics Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 2 of 10Page 2 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: SS-2 @ 12' Lab ID: 24F2063-02Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:30 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic %6/26/246/25/240.1 CTF800094.6Total Solids MBTEXn mg/kg dry 6/25/246/25/240.11 EPA 8260D/5030BNDBenzene mg/kg dry 6/25/246/25/240.26 EPA 8260D/5030BNDEthylbenzene mg/kg dry 6/25/246/25/240.16 EPA 8260D/5030BNDMethyl tert-Butyl Ether (MTBE) mg/kg dry 6/25/246/25/240.26 EPA 8260D/5030BNDNaphthalene mg/kg dry 6/25/246/25/240.26 EPA 8260D/5030BNDToluene mg/kg dry 6/25/246/25/240.79 EPA 8260D/5030BNDXylenes, total Gasoline Range mg/kg dry 6/25/246/25/242.64 EPA 8260B/C 5035A/[CALC]NDGasoline Range Organics Diesel Range mg/kg dry 6/26/246/25/2453EPA 8015 CNDDiesel Range Organics Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 3 of 10Page 3 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: SS-3 @ 12' Lab ID: 24F2063-03Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:35 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic %6/26/246/25/240.1 CTF800092.5Total Solids MBTEXn mg/kg dry 6/25/246/25/240.11 EPA 8260D/5030BNDBenzene mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDEthylbenzene mg/kg dry 6/25/246/25/240.16 EPA 8260D/5030BNDMethyl tert-Butyl Ether (MTBE) mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDNaphthalene mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDToluene mg/kg dry 6/25/246/25/240.81 EPA 8260D/5030BNDXylenes, total Gasoline Range mg/kg dry 6/25/246/25/242.70 EPA 8260B/C 5035A/[CALC]NDGasoline Range Organics Diesel Range mg/kg dry 6/26/246/25/2454EPA 8015 CNDDiesel Range Organics Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 4 of 10Page 4 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: SS-4 @ 12' Lab ID: 24F2063-04Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:45 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic %6/26/246/25/240.1 CTF800093.5Total Solids MBTEXn mg/kg dry 6/25/246/25/240.11 EPA 8260D/5030BNDBenzene mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDEthylbenzene mg/kg dry 6/25/246/25/240.16 EPA 8260D/5030BNDMethyl tert-Butyl Ether (MTBE) mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDNaphthalene mg/kg dry 6/25/246/25/240.27 EPA 8260D/5030BNDToluene mg/kg dry 6/25/246/25/240.80 EPA 8260D/5030BNDXylenes, total Gasoline Range mg/kg dry 6/25/246/25/242.68 EPA 8260B/C 5035A/[CALC]NDGasoline Range Organics Diesel Range mg/kg dry 6/26/246/25/2454EPA 8015 CNDDiesel Range Organics Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 5 of 10Page 5 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: SS-5 @ 3' Lab ID: 24F2063-05Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:55 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic %6/26/246/25/240.1 CTF800088.2Total Solids MBTEXn mg/kg dry 6/25/246/25/240.11 EPA 8260D/5030BNDBenzene mg/kg dry 6/25/246/25/240.28 EPA 8260D/5030BNDEthylbenzene mg/kg dry 6/25/246/25/240.17 EPA 8260D/5030BNDMethyl tert-Butyl Ether (MTBE) mg/kg dry 6/25/246/25/240.28 EPA 8260D/5030BNDNaphthalene mg/kg dry 6/25/246/25/240.28 EPA 8260D/5030BNDToluene mg/kg dry 6/25/246/25/240.85 EPA 8260D/5030BNDXylenes, total Gasoline Range mg/kg dry 6/25/246/25/242.83 EPA 8260B/C 5035A/[CALC]NDGasoline Range Organics Diesel Range mg/kg dry 6/26/246/25/2457EPA 8015 CNDDiesel Range Organics Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 6 of 10Page 6 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: USC-1 @ 12' Lab ID: 24F2063-06Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:25 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic -6/25/246/25/24ASTM D2487-ModGPUnited Soil Classification [USC] Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 7 of 10Page 7 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Sample ID: USC-2 @ 3' Lab ID: 24F2063-07Matrix: Solid Flag(s)Units Analysis Date/Time Date Sampled: 6/25/24 10:25 Preparation Date/Time Sampled By: Troy Spackman Minimum Reporting Limit MethodResult Inorganic -6/25/246/25/24ASTM D2487-ModSCUnited Soil Classification [USC] Project Name: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 8 of 10Page 8 of 10 xx Chemtech-Ford Laboratories Serving the Intermountain West Since 1953 Certificate of Analysis 9632 South 500 West Sandy, UT 84070 O:(801) 262-7299 F: (866) 792-0093 www.ChemtechFord.com Spackman Enterprises, L.C. Troy Spackman PO Box 1276 Centerville, UT 84014-5276 PO#: Receipt: Date Reported: Project Name: 6/25/24 14:38 @ 7.0 °C 6/27/2024 Weber County Eden Report Footnotes Abbreviations ND = Not detected at the corresponding Minimum Reporting Limit (MRL). 1 mg/L = one milligram per liter or 1 mg/kg = one milligram per kilogram = 1 part per million. 1 ug/L = one microgram per liter or 1 ug/kg = one microgram per kilogram = 1 part per billion. 1 ng/L = one nanogram per liter or 1 ng/kg = one nanogram per kilogram = 1 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: Weber County Eden CtF WO#: 24F2063 www.ChemtechFord.com Page 9 of 10Page 9 of 10 Page 10 of 10 Weber County Eden Closure Notice Final Audit Report 2024-08-26 Created:2024-08-23 By:Aaron Spackman (aspackman@spackmanenterprises.com) Status:Signed Transaction ID:CBJCHBCAABAAxI52unGIR6un8lLa9bcO30Q6MOAz7ELp "Weber County Eden Closure Notice" History Document created by Aaron Spackman (aspackman@spackmanenterprises.com) 2024-08-23 - 6:22:42 PM GMT Document emailed to Brett Gurney (brettgurney@utah.gov) for signature 2024-08-23 - 6:22:51 PM GMT Document e-signed by Brett Gurney (brettgurney@utah.gov) Signature Date: 2024-08-26 - 1:13:31 PM GMT - Time Source: server Agreement completed. 2024-08-26 - 1:13:31 PM GMT