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Home My WebLink AboutDERR-2024-012125EZY CHEK SYSTEMS TEST DATE PRODUCT LINE TESTER Testing Company Information DATA SHEET Name Address City Test Location Information Precision Testing Technologies, Inc. 2026 W. Elk Creek Crt. Bluffdale, UT Test Location Information Phone Name Address Technican Information City Name Phone Cert # 801-886-9224 Contact Applied Pressure #1 Product Type:#2 Product Type: TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH 0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000 0.0037 0.00370.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 FINAL RESULT:FINAL RESULT: #3 Product Type:#4 Product Type: TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH 0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.00370.0037 0.0037 0.0037 0.0037 FINAL RESULT:FINAL RESULT: #5 Product Type:#6 Product Type: TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH 0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.000000.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 0.0037 FINAL RESULT:FINAL RESULT: Facility ID# : 07/18/2023 Pilot Thomas #8718 890 N 2000 W Ogden, UT 432-210-0629 Nathan Long 55 PSI Regular 0 55 15 55 0 0 0 30 55 0 0 0 Pass Premium 0 61 15 61 0 0 0 30 61 0 0 0 Pass Diesel 0 78 15 78 0 0 0 30 78 0 0 0 Pass Biodiesel 0 27 15 27 0 0 0 30 27 0 0 0 Pass Red Diesel 0 39 15 39 0 0 0 30 39 0 0 0 Pass 07/18/2023 John Labrum UT-0148 NA - AST Annual Checklist Page 1 of 4 STI SP001 Annual Inspection Checklist General Inspection Information: Inspection Date: __________________ Prior Inspection Date: _________________ Retain until date: __________________ Inspector Name (print):________________________________________________________________ Title: _____________________________ Inspector’s Signature: ___________________________________________________________________________ Tank(s) inspected ID ___________________________________________________________________ Regulatory facility name and ID number (if applicable) ____________________________________________________________________ Inspection Guidance: ¾This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). ¾For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ¾The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. ¾Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. ¾In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper operation (40 CFR 112.8(c)(8)(v)). ¾Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comm ent section. ¾Retain the completed checklists for at least 36 months. ¾Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. ¾Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. ,7(067$786&200(176'$7(&255(&7(' Tank Foundation/Supports 1 Free of tank settlement or foundation washout? 2 Concrete pad or ring wall free of cracking and spalling? 07/18/2023 Premium Pilot Thomas #8718 Yes Yes John Labrum UT-0148 UST Tester Annual Checklist Page 2 of 4 3 Tank supports in satisfactory condition? 4 Is water able to drain away from tank if tank is resting on a foundation or on the ground? 5 Is the grounding strap between the tank and foundation/supports in good condition? Tank Shell, Heads and Roof 6 Free of visible signs of coating failure? 7 Free of noticeable distortions, buckling, denting, or bulging? 8 Free of standing water on roof? 9 Are all labels and tags intact and legible? Tank Manways, Piping, and Equipment 10 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Tank Equipment 11 Normal and emergency vents free of obstructions? 12 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent? 13 Are flame arrestors free of corrosion and are air passages free of blockage? 14 Is the emergency vent in good working condition and functional, as required by manufacturer? Consult manufacturer’s requirements. Verify that components are moving freely (including long-bolt manways). 15 Is interstitial leak detection equipment in good condition? Are windows on sight gauges clear? Are wire connections intact? If equipment has a test function, does it activate to confirm operation?” Yes NA Yes Yes Yes Yes Yes Yes Yes NA NA Yes NA Annual Checklist Page 3 of 4 16 Are all valves free of leaks, corrosion and other damage? Follow manufacturers’ instructions for regular maintenance of these items. Check the following and verify (as applicable): □1. Anti-siphon valve □2. Check valve □3. Gate valve □4. Pressure regulator valve □5. Expansion relief valve □6. Solenoid valve □7. Fire valve □8. Shear valve 17 Are strainers and filters clean and in good condition? Insulated Tanks 18 Free of missing insulation? Insulation free of visible signs of damage? Insulation adequately protected from water intrusion? 19 Insulation free of noticeable areas of moisture? 20 Insulation free of mold? 21 Free of visible signs of coating failure? Tank / Piping Release Detection 22 Is inventory control being performed and documented if required? 23 Is release detection being performed and documented if required? Other Equipment 24 Are electrical wiring and boxes in good condition? 25 Has the cathodic protection system on the tank been tested as required by the designing engineer? 1. 2. 3. 4. 5. 6. 7. 8. NA No NA NA NA NA NA Yes Check Valve has been painted over, non functional. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Annual Checklist Page 4 of 4 Additional Comments: No spill Containment for tank. Annual Checklist Page 1 of 4 STI SP001 Annual Inspection Checklist General Inspection Information: Inspection Date: __________________ Prior Inspection Date: _________________ Retain until date: __________________ Inspector Name (print):________________________________________________________________ Title: _____________________________ Inspector’s Signature: ___________________________________________________________________________ Tank(s) inspected ID ___________________________________________________________________ Regulatory facility name and ID number (if applicable) ____________________________________________________________________ Inspection Guidance: ¾This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). ¾For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ¾The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. ¾Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. ¾In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper operation (40 CFR 112.8(c)(8)(v)). ¾Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comm ent section. ¾Retain the completed checklists for at least 36 months. ¾Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. ¾Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. ,7(067$786&200(176'$7(&255(&7(' Tank Foundation/Supports 1 Free of tank settlement or foundation washout? 2 Concrete pad or ring wall free of cracking and spalling? 07/18/2023 Red Diesel Pilot Thomas #8718 Yes Yes UST TesterJohn Labrum UT-0148 Annual Checklist Page 2 of 4 3 Tank supports in satisfactory condition? 4 Is water able to drain away from tank if tank is resting on a foundation or on the ground? 5 Is the grounding strap between the tank and foundation/supports in good condition? Tank Shell, Heads and Roof 6 Free of visible signs of coating failure? 7 Free of noticeable distortions, buckling, denting, or bulging? 8 Free of standing water on roof? 9 Are all labels and tags intact and legible? Tank Manways, Piping, and Equipment 10 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Tank Equipment 11 Normal and emergency vents free of obstructions? 12 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent? 13 Are flame arrestors free of corrosion and are air passages free of blockage? 14 Is the emergency vent in good working condition and functional, as required by manufacturer? Consult manufacturer’s requirements. Verify that components are moving freely (including long-bolt manways). 15 Is interstitial leak detection equipment in good condition? Are windows on sight gauges clear? Are wire connections intact? If equipment has a test function, does it activate to confirm operation?” Yes NA Yes Yes Yes Yes Yes Yes Yes NA NA Yes NA Annual Checklist Page 3 of 4 16 Are all valves free of leaks, corrosion and other damage? Follow manufacturers’ instructions for regular maintenance of these items. Check the following and verify (as applicable): □1. Anti-siphon valve □2. Check valve □3. Gate valve □4. Pressure regulator valve □5. Expansion relief valve □6. Solenoid valve □7. Fire valve □8. Shear valve 17 Are strainers and filters clean and in good condition? Insulated Tanks 18 Free of missing insulation? Insulation free of visible signs of damage? Insulation adequately protected from water intrusion? 19 Insulation free of noticeable areas of moisture? 20 Insulation free of mold? 21 Free of visible signs of coating failure? Tank / Piping Release Detection 22 Is inventory control being performed and documented if required? 23 Is release detection being performed and documented if required? Other Equipment 24 Are electrical wiring and boxes in good condition? 25 Has the cathodic protection system on the tank been tested as required by the designing engineer? 1. 2. 3. 4. 5. 6. 7. 8. NA No NA NA NA NA NA Yes Check Valve has been painted over, non functional. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Annual Checklist Page 4 of 4 Additional Comments: No spill Containment for tank. Annual Checklist Page 1 of 4 STI SP001 Annual Inspection Checklist General Inspection Information: Inspection Date: __________________ Prior Inspection Date: _________________ Retain until date: __________________ Inspector Name (print):________________________________________________________________ Title: _____________________________ Inspector’s Signature: ___________________________________________________________________________ Tank(s) inspected ID ___________________________________________________________________ Regulatory facility name and ID number (if applicable) ____________________________________________________________________ Inspection Guidance: ¾This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). ¾For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ¾The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. ¾Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. ¾In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper operation (40 CFR 112.8(c)(8)(v)). ¾Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comm ent section. ¾Retain the completed checklists for at least 36 months. ¾Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. ¾Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. ,7(067$786&200(176'$7(&255(&7(' Tank Foundation/Supports 1 Free of tank settlement or foundation washout? 2 Concrete pad or ring wall free of cracking and spalling? 07/18/2023 Regular Pilot Thomas #8718 Yes Yes John Labrum UT-0148 UST Tester Annual Checklist Page 2 of 4 3 Tank supports in satisfactory condition? 4 Is water able to drain away from tank if tank is resting on a foundation or on the ground? 5 Is the grounding strap between the tank and foundation/supports in good condition? Tank Shell, Heads and Roof 6 Free of visible signs of coating failure? 7 Free of noticeable distortions, buckling, denting, or bulging? 8 Free of standing water on roof? 9 Are all labels and tags intact and legible? Tank Manways, Piping, and Equipment 10 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Tank Equipment 11 Normal and emergency vents free of obstructions? 12 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent? 13 Are flame arrestors free of corrosion and are air passages free of blockage? 14 Is the emergency vent in good working condition and functional, as required by manufacturer? Consult manufacturer’s requirements. Verify that components are moving freely (including long-bolt manways). 15 Is interstitial leak detection equipment in good condition? Are windows on sight gauges clear? Are wire connections intact? If equipment has a test function, does it activate to confirm operation?” Yes NA Yes Yes Yes Yes Yes Yes Yes NA NA Yes NA Annual Checklist Page 3 of 4 16 Are all valves free of leaks, corrosion and other damage? Follow manufacturers’ instructions for regular maintenance of these items. Check the following and verify (as applicable): □1. Anti-siphon valve □2. Check valve □3. Gate valve □4. Pressure regulator valve □5. Expansion relief valve □6. Solenoid valve □7. Fire valve □8. Shear valve 17 Are strainers and filters clean and in good condition? Insulated Tanks 18 Free of missing insulation? Insulation free of visible signs of damage? Insulation adequately protected from water intrusion? 19 Insulation free of noticeable areas of moisture? 20 Insulation free of mold? 21 Free of visible signs of coating failure? Tank / Piping Release Detection 22 Is inventory control being performed and documented if required? 23 Is release detection being performed and documented if required? Other Equipment 24 Are electrical wiring and boxes in good condition? 25 Has the cathodic protection system on the tank been tested as required by the designing engineer? 1. 2. 3. 4. 5. 6. 7. 8. NA No NA NA NA NA NA Yes Check Valve has been painted over, non functional. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Annual Checklist Page 4 of 4 Additional Comments: No spill Containment for tank. Annual Checklist Page 1 of 4 STI SP001 Annual Inspection Checklist General Inspection Information: Inspection Date: __________________ Prior Inspection Date: _________________ Retain until date: __________________ Inspector Name (print):________________________________________________________________ Title: _____________________________ Inspector’s Signature: ___________________________________________________________________________ Tank(s) inspected ID ___________________________________________________________________ Regulatory facility name and ID number (if applicable) ____________________________________________________________________ Inspection Guidance: ¾This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). ¾For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ¾The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. ¾Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. ¾In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper operation (40 CFR 112.8(c)(8)(v)). ¾Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comm ent section. ¾Retain the completed checklists for at least 36 months. ¾Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. ¾Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. ,7(067$786&200(176'$7(&255(&7(' Tank Foundation/Supports 1 Free of tank settlement or foundation washout? 2 Concrete pad or ring wall free of cracking and spalling? 07/18/2023 Biodiesel Pilot Thomas #8718 Yes Yes John Labrum UT-0148 UST Tester Annual Checklist Page 2 of 4 3 Tank supports in satisfactory condition? 4 Is water able to drain away from tank if tank is resting on a foundation or on the ground? 5 Is the grounding strap between the tank and foundation/supports in good condition? Tank Shell, Heads and Roof 6 Free of visible signs of coating failure? 7 Free of noticeable distortions, buckling, denting, or bulging? 8 Free of standing water on roof? 9 Are all labels and tags intact and legible? Tank Manways, Piping, and Equipment 10 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Tank Equipment 11 Normal and emergency vents free of obstructions? 12 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent? 13 Are flame arrestors free of corrosion and are air passages free of blockage? 14 Is the emergency vent in good working condition and functional, as required by manufacturer? Consult manufacturer’s requirements. Verify that components are moving freely (including long-bolt manways). 15 Is interstitial leak detection equipment in good condition? Are windows on sight gauges clear? Are wire connections intact? If equipment has a test function, does it activate to confirm operation?” Yes NA Yes Yes Yes Yes Yes Yes Yes NA NA Yes NA Annual Checklist Page 3 of 4 16 Are all valves free of leaks, corrosion and other damage? Follow manufacturers’ instructions for regular maintenance of these items. Check the following and verify (as applicable): □1. Anti-siphon valve □2. Check valve □3. Gate valve □4. Pressure regulator valve □5. Expansion relief valve □6. Solenoid valve □7. Fire valve □8. Shear valve 17 Are strainers and filters clean and in good condition? Insulated Tanks 18 Free of missing insulation? Insulation free of visible signs of damage? Insulation adequately protected from water intrusion? 19 Insulation free of noticeable areas of moisture? 20 Insulation free of mold? 21 Free of visible signs of coating failure? Tank / Piping Release Detection 22 Is inventory control being performed and documented if required? 23 Is release detection being performed and documented if required? Other Equipment 24 Are electrical wiring and boxes in good condition? 25 Has the cathodic protection system on the tank been tested as required by the designing engineer? 1. 2. 3. 4. 5. 6. 7. 8. NA No NA NA NA NA NA Yes Check Valve has been painted over, non functional. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Annual Checklist Page 4 of 4 Additional Comments: No spill Containment for tank. Annual Checklist Page 1 of 4 STI SP001 Annual Inspection Checklist General Inspection Information: Inspection Date: __________________ Prior Inspection Date: _________________ Retain until date: __________________ Inspector Name (print):________________________________________________________________ Title: _____________________________ Inspector’s Signature: ___________________________________________________________________________ Tank(s) inspected ID ___________________________________________________________________ Regulatory facility name and ID number (if applicable) ____________________________________________________________________ Inspection Guidance: ¾This checklist is intended as a model. Locally developed checklists are acceptable as long as they are substantially equivalent (as applicable). ¾For equipment not included in this Standard, follow the manufacturer recommended inspection/testing schedules and procedures. ¾The periodic AST Inspection is intended for monitoring the external AST condition and its containment structure. This visual inspection does not require a Certified Inspector. It shall be performed by an owner’s inspector per paragraph 4.1.2 of the standard. ¾Remove promptly standing water or liquid discovered in the primary tank, secondary containment area, interstice, or spill container. Before discharge to the environment, inspect the liquid for regulated products or other contaminants and disposed of it properly. ¾In order to comply with EPA SPCC (Spill Prevention, Control and Countermeasure) rules, a facility should regularly test liquid level sensing devices to ensure proper operation (40 CFR 112.8(c)(8)(v)). ¾Non-conforming items important to tank or containment integrity require evaluation by an engineer experienced in AST design, a Certified Inspector, or a tank manufacturer who will determine the corrective action. Note the non-conformance and corresponding corrective action in the comm ent section. ¾Retain the completed checklists for at least 36 months. ¾Complete this checklist on an annual basis, supplemental to the owner monthly-performed inspection checklists. ¾Note: If a change has occurred to the tank system or containment that may affect the SPCC plan, the condition should be evaluated against the current plan requirement by a Professional Engineer knowledgeable in SPCC development and implementation. ,7(067$786&200(176'$7(&255(&7(' Tank Foundation/Supports 1 Free of tank settlement or foundation washout? 2 Concrete pad or ring wall free of cracking and spalling? 07/18/2023 Diesel Pilot Thomas #8718 Yes Yes John Labrum UT-0148 UST Tester Annual Checklist Page 2 of 4 3 Tank supports in satisfactory condition? 4 Is water able to drain away from tank if tank is resting on a foundation or on the ground? 5 Is the grounding strap between the tank and foundation/supports in good condition? Tank Shell, Heads and Roof 6 Free of visible signs of coating failure? 7 Free of noticeable distortions, buckling, denting, or bulging? 8 Free of standing water on roof? 9 Are all labels and tags intact and legible? Tank Manways, Piping, and Equipment 10 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Tank Equipment 11 Normal and emergency vents free of obstructions? 12 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent? 13 Are flame arrestors free of corrosion and are air passages free of blockage? 14 Is the emergency vent in good working condition and functional, as required by manufacturer? Consult manufacturer’s requirements. Verify that components are moving freely (including long-bolt manways). 15 Is interstitial leak detection equipment in good condition? Are windows on sight gauges clear? Are wire connections intact? If equipment has a test function, does it activate to confirm operation?” Yes NA Yes Yes Yes Yes Yes Yes Yes NA NA Yes NA Annual Checklist Page 3 of 4 16 Are all valves free of leaks, corrosion and other damage? Follow manufacturers’ instructions for regular maintenance of these items. Check the following and verify (as applicable): □1. Anti-siphon valve □2. Check valve □3. Gate valve □4. Pressure regulator valve □5. Expansion relief valve □6. Solenoid valve □7. Fire valve □8. Shear valve 17 Are strainers and filters clean and in good condition? Insulated Tanks 18 Free of missing insulation? Insulation free of visible signs of damage? Insulation adequately protected from water intrusion? 19 Insulation free of noticeable areas of moisture? 20 Insulation free of mold? 21 Free of visible signs of coating failure? Tank / Piping Release Detection 22 Is inventory control being performed and documented if required? 23 Is release detection being performed and documented if required? Other Equipment 24 Are electrical wiring and boxes in good condition? 25 Has the cathodic protection system on the tank been tested as required by the designing engineer? 1. 2. 3. 4. 5. 6. 7. 8. NA No NA NA NA NA NA Yes Check Valve has been painted over, non functional. Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Annual Checklist Page 4 of 4 Additional Comments: No spill Containment for tank.