DERR-2024-010857

WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

LIQUID SENSER FUNCTIONALITY TESTING
Facility Name: Intermountain Medical Center (DSL Tanks) Owner: Intermountain Medical Center
Address: 5180 South Intermountain Drive Address: 5121 South Cottonwood Street
City, State, Zip: Salt Lake City, Utah 84107 City, State, Zip: Murray, Utah 84107
Facility I.D.#: 4002369 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 7/10/24
This procedure is to determine whether liquid sensors, located in the interstitial spaces of the UST systems, are able to detect the presence of water and fuel. See
PEI/RP1200, Section 8.3 for the test procedure.
Sensor Location L1 Wes t STP L2 West STP L3 West INT L4 East STP L5 East STP L6 East INT
Product Stored DSL DSL DSL DSL DSL DSL
Type of Sensor
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☒ Non-Discrimi-
nating
☐ Discriminating
☐ Non-Discrimi-
nating
Test Liquid ☒ Water
☐ Product
☒ Water
☐ Product
☒ Water
☐ Product
☒ Water
☐ Product
☒ Water
☐ Product
☒ Water
☐ Product
☐ Water
☐ Product
Is the ATG Console clear of any active or
recurring warnings or alarms regarding
the leak sensor? If the sensor is in alarm
and functioning, indicate why.
☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No
Is sensor alarm circuit
operational? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No
Has sensor been inspected and in good
operating condition? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No
When placed in test liquid, does the
sensor trigger an alarm? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No
When alarm is trigger, is the sensor
identified on the ATG console? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No
Any “No” answers indicate the sensor fails the test.
Test Results: ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☐ Pass ☐ Fail
Comments: Sensor L4 was replaced and retested on 8/15/24.
Tester’s Name: Taber DeHart, UT-0394 Tester’s Signature