HomeMy WebLinkAboutDERR-2024-011103Page l ofヱ Utah Department of Environmental Quality
UST Release Detection lnspection
0100524
Ownership of Tanks Location ot Tanks
MAVERIК :NC MA/ER K″604
185 SOUTH STATE STREET STE 300 790E1400N
SALT LAKE C[TY IυT 84111 LOGAN U了 184341
OP A:MAMuN MSHID (801)9107062 oPB MAMUN RAsHto l(80l,910-2062
V.rlfy l..t on tant d.i. 3hot
.m cuE nt.nd 6. trL ATC system:ぐこ覇
' No NA
S nOい waled Sp,bucke`|Yes No d^)
O No NA ovenl devicel ⑮ No NA
line lighr'es(suctioo 3yr):Yes No 6P G, No NA
Yes No @
Cath“c Proleclon Yes No @
Compl.t. tor .ach iank.1(Ч ヽ ′〈`“#capacity or tank (gattons):12ooo ●¨
Rc“|.r ,に _.“颯
Oale last used/depth oi product
Typo of spill prove.lion devics:bO S■,い 免
OouЫ o walbd spil bu“el eaU9。iScは ed month,y and valdi @ro u ゆ No NA Ves No NA Yes No NA Yes No NA Yes No NA
Spill buck6l is cloan. iniacr. er.ご
“
O No ´ N。
Typ€ ol ovorfitt Provonton devi.€:A"Aわ
Overlill alarm (aldtbt€ orvisibto)is proporly tocaied so delivery d ver can hearor soe it and is ctearty ide.titied Yes No @
c鵜 ]棚 辮 旧 署 鍋:``
‐7ミ
“,Cmtainri€nt sumps dry:CG, No NA とョ) No NA Ves No NA Yes No NA Yes No NA Yes No NA
Stago 1 Vapor Rocoveryl @cod Noie @coax Non€20t
Prcssure V6ntValve is on venis:Ves No NA Yes No NA Yes No NA Yes No NA Yos No NA Ves No NACompl.l. lor .ach dt.p€n..r ″ `′ι #_`/ャ ″″
Cathodi『告潮麗裾ギ1鯉 露「まば謡,Ч,C tt,C
― No NA ∂ No NA Yes No NA Yes No NA Ves No NA Yes No NA
DW piping h6v6iump€B in ptac€:Ves No NA Yes No NA Yes No NA Yes No NAFire valve anchored Ocaled bem
grade and wthout●81 ValVei
Yes No NA Yes No NA Ves No NA Ves No NA Yes No NA Ves No NA
Addition.l disp.nser qu*rions###“#Cabod[R酬 響剛識 %織 £,@N" na Ves No NA Ves No NA Yes No NA Ves No NA
OW piping have junpoB an plac6:Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Firs vatu6 anchorod, toc€tod b€low
glad€, and no baltvatvo:
Yes No NA Ves No NA Ves No NA Yes No NA Yes No NA Yes No NA
hpress.d Cuaent C.thodlc Protection Lasr rh,e dares €ctlier checked
Financla!Responslb∥lty(State use only)
― N。FR MethOdl Mehod oK? | Yes No by:
O No・C・ Operators taned。「unmanned s,Ы 9n`Й sb e?|こ 菫5)No NA Age Zet- Insp€crod rh6 raorry ontVr{/}tlf lhe sls is unma.nod and dtspen*s ruer. aEi ,t trii.
an €msQoncy shutoff dsvice?o No NA 油°場上ニT|02'3Monthtt cheCkI St ava,い Ob and complete?0生 ぶゝ No
ンOS倅``:サ
ノ 1
Pago 2 o, 2_
[t Monthly monltorins
1 2 0ph monthly test
l SiR
いいlerSJJ mO●lonng
〔1 0W monloing
ryp€ ot lM? d1'6' Manuar
Tank and Piping Release Detection
Automatic Tank Gauging/lnterstitial Monitoring
T..k. ln.t lled aft.r octob.r 1,2008 mulr do lni6Btitial ilonhoring.
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Tank method u3●●:: l ATG Shuldown lest I I ATG conl ouous tesl xl lnteBtiriar Moniroring
M.nvfuclurer and ilod.lol iysr6m:ヽ.4′ 0し0キ S・ tt 50
Circle Yas or Nofor€ach question. ln the lasl column explain a.d iden rybytank anyexc6ptio.slo theansw66 given in rh6 ti6t cotumn
Typ€ o, s€condary @nrainm6ni lsod Typ6 oflM documentation us€d ATG Marlat
SFl6m is capabb ol d6t6ctjng a El6a* ol mgutat6d slbstan@s tw any
porton ol nle pnhary tanUpiping wihin one montt of rcleas:
ATG consle or oihsr €quipmont us6d to take readlngsand p6dom tests is
ad€quato, ac@ssibt6, and op€rationat:
The tank was lled to atleastthe min mumに velrequ,ed lo ensure a vald bak
tosl andthetank size s with n tre a kЖ ed upperarl l●●er sizo lmils:
TM“詢,Mh[0媚 柿 団k
l●●●●●ltr ATC S、¨t醸 ‐
Show re.ult ol monlloring for 6ach tank lor lhe l..t i 2 fro.ihr. lndicaie P..., Fail, tnv.tld, or No R.suttr fo. oactr monrn. ror lre Struraom tests,3howth. high$r product tevot r..r.d tor..ch month.
lndlcrt. tho method us6d:
PBsuriz€d piping must havs .h Aulomric Line Leak D€rocior and ons olner fom ol r€ak dstsction
Suciion piping musl bs testsd 6v€ry 3 yea6 or have montht monhoring. ll safe sucrion, reak det€crion is dslered
m Lln€ Lort Oeiect.r lGring Pipi.g lnst llod aft6r Ocrob€r l,2008 must do lnreEtlrlalMonitoring.
[ ) Lino Ilshtn6s Testing
Ver 10′5′2018