DERR-2024-011969

GALVANIC (SACRIFICIAL ANODE) CATHODIC PROTECTION SYSTEM EVALUATION
DEQ Underground Storage Tank Program
TESTING PER CRITERIA & STANDARDS ESTABLISHED BY NACE AND/OR STI (STEEL TANK INSTITUTE)
• Access to the soil directly over the cathodically protected structure that is being evaluated must be provided.
• A site drawing depicting the UST cathodic protection system and all reference electrode placements must be completed.
I. UST OWNER II. UST FACILITY
COMPANY NAME: RICHARD L. MILLER
ADDRESS: 2455 WEST MAIN STREET
CITY: FAIRVIEW STATE: UT ZIP: 84629
FACILITY NAME: MILLERS FAIRVIEW
FACILITY ID#: 2000228
FACILITYADDRESS: 334 NORTH STATE STREET
CITY: FAIRVIEW STATE: UT ZIP: 84629 COUNTY: SAN PETE
III. CP TESTER IV. CP TESTER’S QUALIFICATIONS
TESTER’S NAME: BRYER DUNCAN
COMPANY NAME: M&M CATHODIC PROTECTION
ADDRESS: 303 REDBERRY RD.
CITY: DRAPER STATE: UT ZIP: 84020
PHONE NUMBER: [phone]
CP TESTERS CERTIFICATION NUMBER(s) & EXPIRATION DATE(s):
STEEL TANK INSTITUTE CP INSPECTOR: #CP-16578 EXP:11-18-2024
UTAH: CP TESTER #UT404 EXPIRES 1-18-2026
WYOMING: CP TESTER #CP-2021-C-10 EXPIRES 11-18-2024
V. REASON SURVEY WAS CONDUCTED (mark only one)
Routine - 3 year Routine – within 6 months of installation 90-day re-survey after fail Re-survey after repair/modification
Date next cathodic protection survey must be conducted no later than: 7-30-27 (required within 6 months of installation/repair & every 3 years thereafter).
VI. CATHODIC PROTECTION TESTER’S EVALUATION (mark only one)
PASS All protected structures at this facility pass the cathodic protection survey and it is judged that adequate cathodic protection has been
provided to the UST system (indicate all criteria applicable by completion of Section VIII).

FAIL One or more protected structures at this facility fail the cathodic protection survey and it is judged that adequate cathodic protection
has not been provided to the UST system (complete Section IX).

INCONCLUSIVE If the remote and the local do not both indicate the same test result on all protected structures (both pass or both fail), inconclusive is
indicated and the survey must be evaluated and/or conducted by a corrosion expert (complete Section VII).

CP TESTER’S SIGNATURE:

DATE CP SURVEY PERFORMED: 7-30-24

VII. CORROSION EXPERT’S EVALUATION (mark only one)
The survey must be conducted and/or evaluated by a corrosion expert when: a) an inconclusive is indicated for any protected structure since both the local and the
remote structure-to-soil potentials do not result in the same outcome (both pass or both fail); b) repairs to galvanized or uncoated steel piping are conducted or c)
supplemental anodes are added to the tanks and/or piping without following an accepted industry code.
PASS All protected structures at this facility pass the cathodic protection survey and it is judged that adequate cathodic protection has been
provided to the UST system (indicate all criteria applicable by completion of Section VIII).

FAIL One or more protected structures at this facility fail the cathodic protection survey and it is judged that adequate cathodic protection
has not been provided to the UST system (complete Section IX).
CORROSION EXPERT’S NAME: COMPANY NAME:
NACE INTERNATIONAL CERTIFICATION: NACE INTERNATIONAL CERTIFICATION NUMBER:

CORROSION EXPERT'S SIGNATURE:

DATE REVIEWED:
VIII. CRITERIA APPLICABLE TO EVALUATION (mark all that apply)
-850 ON Structure-to-soil potential more negative than –850 mV with respect to a Cu/CuSO4 reference electrode with the protective current applied
(This criterion is applicable to any galvanically protected structure).

-850 OFF Structure-to-soil potential more negative than –850 mV with respect to a Cu/CuSO4 reference electrode with protective current temporarily
interrupted (This criterion is applicable only to those galvanic systems where the anodes can be disconnected).

100mV POLARIZ. Structure tested exhibits at least 100 mV of cathodic polarization (This criterion is applicable to galvanic systems where the anodes can be
temporarily disconnected). Additionally, this criteria requires a recorded NATIVE, PRE-CP, or DEPOL to satisfy criteria. (include in NOTES)
IX. ACTION REQUIRED AS A RESULT OF THIS EVALUATION (mark only one)
NONE Cathodic protection is adequate. No further action is necessary at this time. Test again by no later than (see Section V).

RETEST Cathodic protection may not be adequate. Retest during the next 90 days to determine if passing results can be achieved.

REPAIR/RETEST Cathodic protection is not adequate. Repair/modification is necessary as soon as practical but within the next 90 days.

X. DESCRIPTION OF UST SYSTEM
TANK # PRODUCT CAPACITY TANK MATERIAL PIPING MATERIAL FLEX CONNECTORS
1 DSL 9,000 GAL STIP3 PLASTIC ALL FLEXS IN CONTAIN.
2 PREM 10,000 GAL STIP3 PLASTIC ALL FLEXS IN CONTAIN.
3 UNL 10,000 GAL STIP3 PLASTIC ALL FLEXS IN CONTAIN.
4
5
6
7
8
9
10
XI. DESCRIPTION OF CATHODIC PROTECTION SYSTEM REPAIRS AND/OR MODIFICATION
Complete if any repairs or modifications to the cathodic protection system are made OR are necessary. Certain repairs/modifications are required to be
designed and/or evaluated by a corrosion expert (completion of Section VII required).
Supplemental anodes for a STIP3® tank (attach corrosion expert’s design or documention industry standard was followed).
Supplemental anodes for metallic pipe (attach corrosion expert’s design or documention industry standard was followed).
Galvanically protected tanks/piping not electrically isolated (explain in “Remarks/Other” below).
REMARKS/OTHER: NO REPAIRS PERFORMED-SURVEY ONLY

XII. UST FACILITY SITE DRAWING
Attach detailed drawing or use the space provided to draw a sketch of the UST and cathodic protection systems. Sufficient detail must be given in order to clearly
indicate where the reference electrode was placed for each structure-to-soil potential that is recorded on the survey forms. Any pertinent data must also be included.
At a minimum you should indicate the following: All tanks, piping and dispensers; All buildings and streets; All anodes and wires; Location of CP test stations; Each
reference electrode placement must be indicated by a code (1,2, T-1,) corresponding with the appropriate line number in Section XIV of this form.
AN EVALUATION OF THE CATHODIC PROTECTION SYSTEM IS NOT COMPLETE WITHOUT AN ACCEPTABLE SITE DRAWING. (LARGER SITE DRAWING IS
ATTACHED TO THIS SURVEY)

XIII. GALVANIC (SACRIFICIAL ANODE) CATHODIC PROTECTION SYSTEM CONTINUITY SURVEY
This section may be utilized to conduct measurements of continuity on underground storage tank systems that are protected by cathodic protection systems.
When conducting a fixed cell - moving ground survey, the reference electrode must be placed in the soil at a remote location and left undisturbed.
Conduct point-to-point test between any two structures for which the fixed cell-moving ground survey is inconclusive or indicates possible continuity.
For galvanic systems, the structure that is to be protected must be isolated from any other metallic structure in order to pass the continuity survey.

NOTE: The survey is not complete unless all applicable parts of sections I-XIV are also completed
DESCRIBE LOCATION OF “FIXED REMOTE” REFERENCE ELECTRODE PLACEMENT: POINT TO POINT CONTINUITY SURVEY WAS CONDUCTED
STRUCTURE “A” 1 STRUCTURE “B” 2 STRUCTURE “A” 3
FIXED REMOTE
INSTANT OFF
VOLTAGE
STRUCTURE “B” 4
FIXED REMOTE
INSTANT OFF
VOLTAGE
POINT-TO-POINT 5
VOLTAGE
DIFFERENCE (mV)
ISOLATED/ 6
CONTINUOUS/
INCONCLUSIVE
(example) PLUS TANK BOTTOM (example) PLUS PRODUCT LINE @ STP (example) -915 mV (example) -999 mV (example) ISOLATED
(example) PLUS TANK BOTTOM (example) PLUS PRODUCT LINE @ STP (example) 22 mV (example) ISOLATED
PREM TANK BOTTOM PREM FILL RISER 370 ISOLATED
PREM ATG RISER PREM ATG RISER 289 ISOLATED
PREM STP RISER PREM STP RISER 368 ISOLATED
PREM VENT PREM VENT 501 ISOLATED
UNL FILL RISER UNL FILL RISER 482 ISOLATED
UNL ATG RISER UNL ATG RISER 409 ISOLATED
UNL STP RISER UNL STP RISER 531 ISOLATED
UNL VENT UNL VENT 662 ISOLATED
DSL FILL RISER DSL FILL RISER 198 ISOLATED
DSL ATG RISER DSL ATG RISER 157 ISOLATED
DSL STP RISER DSL STP RISER 416 ISOLATED
DSL VENT DSL VENT 677 ISOLATED

REMARKS/OTHER: NO ISSUES WITH CONTINUITY

1. Describe the cathodically protected structure that you are attempting to demonstrate is isolated from unprotected structures (e.g. prem. tank).
2. Describe the unprotected structure that you are attempting to demonstrate is isolated from the protected structure (e.g. premium tank fill riser).
3. Record the measured structure-to-soil potential of the cathodically protected structure {“A”} in millivolts (e.g. –921 mV).
4. Record the measured structure-to-soil potential of the unprotected structure {“B”} in millivolts (e.g. –915 mV).
5. Record the voltage observed between the protected and the unprotected structures when conducting point-to-point testing (e.g. 17 mV).
6. Document whether the test (fixed cell and/or point to point) indicated the protected structure was isolated, continuous or inconclusive.

XIV. GALVANIC (SACRIFICIAL ANODE) CATHODIC PROTECTION SYSTEM SURVEY
This section may be utilized to conduct a survey of a galvanic cathodic protection system by obtaining structure-to-soil potential measurements.
The reference electrode must be placed in the soil directly over the tested structure (local) and two additional locations, at least 30 feet away from the structure (2 remotes).
Both the local and the 2 remotes voltage must be -850 mV or more negative (referenced to copper sulfate), in order for the structure to pass.
Per Steel Tank Institute, the 2 remote voltages must be within 10mV of each other to show true remote.
Inconclusive is indicated when both the local and the 2 remote structure-to-soil potentials do not result in the same outcome (both pass or both fail).
NOTE: This survey is not complete unless all applicable parts of sections I – XIV are also completed
LOCATION 1
CODE
STRUCTURE 2 CONTACT POINT 3 REFERENCE CELL PLACEMENT 4
(REMOTES SHOWN AS "REM1 & "REM2" ON SITEMAP)
LOCAL
VOLTAGE 5
(mV)
REMOTE 1
VOLTAGE 6
(mV)
REMOTE 2
VOLTAGE 6
(mV)
PASS / FAIL /
INCONCLUSIVE 9
(example)
1
(example)
PLUS TANK
(example)
TANK BOTTOM
(example)
PLUS TANK STP MANWAY
(example)
-928mV
(example)
-810mV
(example)
-808mV
(example)
PASS
(example)
2
(example)
PLUS PIPING
(example)
DISPENSER 5/6
(example)
UNDER DISPENSER 5/6
(example)
-890 mV
(example)
-885 mV
(example)
-878mV
(example)
PASS
1 DSL TANK TANK BOTTOM BOREHOLE CENTER -1174 -1066 (REM1) -1061 (REM2) PASS
2 PREM TANK TANK BOTTOM BOREHOLE CENTER -1346 -1280 (REM1) -1277 (REM2) PASS
3 UNL TANK TANK BOTTOM BOREHOLE CENTER -1515 -1336 (REM1) -1328 (REM2) PASS
4 - - (REM1) - (REM2)
5 - - (REM1) - (REM2)
6 - - (REM1) - (REM2)
7 - - (REM1) - (REM2)
8 - - (REM1) - (REM2)
9 - - (REM1) - (REM2)
10 - - (REM1) - (REM2)
11 - - (REM1) - (REM2)
12 - - (REM1) - (REM2)
13 - - (REM1) - (REM2)
14 - - (REM1) - (REM2)
15 - - (REM1) - (REM2)
16 - - (REM1) - (REM2)
17 - - (REM1) - (REM2)
18 - - (REM1) - (REM2)
19 - - (REM1) - (REM2)
20 - - (REM1) - (REM2)
21 - - (REM1) - (REM2)
22 - - (REM1) - (REM2)
23 - - (REM1) - (REM2)
24 - - (REM1) - (REM2)
25 - - (REM1) - (REM2)
26 - - (REM1) - (REM2)
27 - - (REM1) - (REM2)
28 - - (REM1) - (REM2)
29 - - (REM1) - (REM2)
30 - - (REM1) - (REM2)
31 - - (REM1) - (REM2)
32 - - (REM1) - (REM2)
33 - - (REM1) - (REM2)
34 - - (REM1) - (REM2)
35 - - (REM1) - (REM2)
36 - - (REM1) - (REM2)
37 - - (REM1) - (REM2)
38 - - (REM1) - (REM2)
39 - - (REM1) - (REM2)
40 - - (REM1) - (REM2)
41 - - (REM1) - (REM2)
REMARKS/OTHER: ALL TANKS PASS MINIMUN REQUIREMENTS FOR CATHODIC PROTECTION PER STI

1. Designate numerically or by code on the site drawing each “local” reference electrode placement (e.g. 1,2,3 T-1, T-2, P-1, P-2etc.).
2. Describe the structure that is being tested (e.g. plus tank; premium piping; diesel submersible pump flex connector; etc.).
3. Describe where contact with the structure that is being tested is made (e.g. plus tank @ test lead; diesel piping @ dispenser 5/6; tank test lead; pp4, etc).
4. Describe the exact location where reference electrode is placed for each “local” measurement (e.g. soil @ plus tank STP; soil @ dispenser 5/6; etc.)
5. Record the structure-to-soil potential measured with the reference electrode placed “local” in millivolts (e.g. –865 mV, -920 mV, etc.).
6. Record the structure-to-soil potential measured with the reference electrode placed at 2 “remote” locations (copy voltage that was obtained during continuity survey).
7. Indicate whether the tested structure passed or failed the –850 mV “on” criterion based on your interpretation of the test data.

ATTACHMENT 1 - LARGER SITE DRAWING:

ATTACHMENT 2 - CERTIFICATION OF CP TESTER:

ATTACHMENT 3 – REFERENCE ELECTRODE CALIBRATION TEST PERFORMED

Copper-Copper Sulfate reference electrode field calibration test (half-cell)

The following reference electrode calibration test is performed quarterly:

Visual inspection: The field reference electrode should always have a quantity of undissolved copper sulfate crystals
present in the solution to assure that the solution is saturated. The solution should be azure blue and clear since
contaminants can make the solution cloudy.

Parts required to perform field calibration test:

QUANTITY DESCRIPTION
1 COPPER-COPPER SULFATE CuCu/SO
4
HALF CELL –
CALIBRATION STANDARD – NOT USED IN FIELD
1 COPPER-COPPER SULFATE CuCu/SO
4
HALF CELL –
TO BE CALIBRATED – FIELD REFERENCE ELECTRODE

INSTRUCTIONS:
1. Place both the CALIBRATION STANDARD – NOT USED IN FIELD half-cell and the half cell to be
calibrated into a container of distilled water.
2. Connect the half-cells to the leads of a voltmeter capable of giving reading in mill volts.
3. Turn on the voltmeter and see if the voltmeter reads a potential difference of (+/-) 10mV or more.
4. Wait up to five (5) minutes.
5. If half-cells show 10mV or more difference of potential, the half-cell being calibrated is out of calibration
and should be replaced or cleaned and re-checked.

ATTACHMENT 4 – FLUKE MULTIMETER CALIBRATION

The following equipment shows the Fluke Multi-meters used for testing of CP potentials for these surveys:

The 77, 87, 175, 177, & 179 Manufacturer’s Calibration Information provides the information necessary to adjust and
verify the performance of the Fluke Models 175, 177, and 179 True RMS Multi-meters.

WE PERFORM A PERFORMANCE TEST ON THESE DEVICES QUARTERLY (within the last 90 days): The
performance tests verify the operation of the Meter when measuring low voltage DC potentials, such as those
encountered during a CP survey. We check the accuracy of each Meter function against its specifications as
referenced to a precision, stable, low-voltage supply reference that is accurate to within 0.007% (plus or minus
350uV) as measured by a calibrated 8.5 digit Keysight 3458A DMM that has an accuracy of 0.0008% (Keysight
Technologies, Loveland Standards and Calibration Labs Certificate of Calibration 1-7581424013-1, (valid through
January 21, 2024). If meter fails any part of the test per specifications of the manufacturer (+/- .09 volt @ 5 VDC ),
calibration adjustment and/or repair is indicated it is sent to the manufacturer for repair and or calibration.

WE PERFORM A CALIBRATION ON THESE DEVICES QUARTERLY (within the last 90 days): Calibration test
of multi-meters was performed against its specifications as referenced to a precision, stable, low-voltage supply, as
indicated above.

Signature showing calibration test of multi-meters completed within the last 90 days:

____________________________
Signature

____________________________
Printed Name

RRRRobert Butner, obert Butner, obert Butner, obert Butner, STI CP INspector/ STI CP INspector/ STI CP INspector/ STI CP INspector/ NACE CP2NACE CP2NACE CP2NACE CP2