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HomeMy WebLinkAboutDERR-2024-012672 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 801-261-4054 AUTOMATIC TANK GAUGE OPERATION INSPECTION Facility Name: St. Joseph Villa Owner: St. Joseph Villa Address: 451 East Bishop Federal Lane Address: 451 East Bishop Federal Lane City, State, Zip: Salt Lake City, Utah 84115 City, State, Zip: Salt Lake City, Utah 84115 Facility I.D.#: 4001703 Phone #: 385-266-2883 Testing Company: Westech Phone #: 801-266-2545 Date: 10/18/24 This procedure is to determine whether the automatic tank gauge (ATG) is operating properly. See PEI/RP1200 Section 8.2 for the inspection procedure. This procedure is applicable to tank monitor stems the touch the bottom of the tank when in place. Tank Number 1 2 Product Stored DSL DSL ATG Brand and Model TMS-2000 TMS-2000 1. Tank Volume, gallons 564 543 2. Tank Diameter, inches 48 47 5/8 3. After removing the ATG from the tank, it has been inspected and any damaged or missing parts replaced? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Float moves freely on the stem without binding? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. Fuel float level agree with the value programmed into the console? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No 6. Water float level agree with the value programmed into the console? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No 7. Inch level from the bottom of the stem when 90% alarm is triggered? 40 1/2 39 5/8 8. Inch level at which the overfill alarm activates corresponds with the value programmed in the gauge? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No 9. Inch level from the bottom when the water float first triggers an alarm? 1 1 10. Inch level at which the water float alarm activates corresponds with the value programmed in the gauge? ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No If any answers in Lines 3, 4, 5, or 6 are "No" the system has failed the test. Test Results ☒Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Battery OK Tester’s Name Taber DeHart, UT-0394 Tester’s Signature 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 801-261-4054 LIQUID SENSER FUNCTIONALITY TESTING Facility Name: St. Joseph Villa Owner: St. Joseph Villa Address: 451 East Bishop Federal Lane Address: 451 East Bishop Federal Lane City, State, Zip: Salt Lake City, Utah 84115 City, State, Zip: Salt Lake City, Utah 84115 Facility I.D.#: 4001703 Phone #: 385-266-2883 Testing Company: Westech Phone #: 801-266-2545 Date: 10/18/24 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 T1 Int Product Stored 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: Tester’s Name: Taber DeHart, UT-0394 Tester’s Signature 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 801-261-4054 OVERFILL ALARM OPERATION INSPECTION Facility Name: St. Joseph Villa Owner: St. Joseph Villa Address: 451 East Bishop Federal Lane Address: 451 East Bishop Federal Lane City, State, Zip: Salt Lake City, Utah 84115 City, State, Zip: Salt Lake City, Utah 84115 Facility I.D.#: 4001703 Phone #: 385-266-2883 Testing Company: Westech Phone #: 801-266-2545 Date: 10/18/24 This procedure is to determine whether the automatic tank gauge (ATG) is operating properly. See PEI/RP1200 Section 8.2 for the inspection procedure. This procedure is applicable to tank monitor stems the touch the bottom of the tank when in place. Tank Number 1 Product Stored DSL ATG Brand and Model TMS-2000 1. Tank Volume, gallons 564 2. Tank Diameter, inches 48 3. Overfill alarm activates in the test mode at the console? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. When activated, overfill alarm can be heard or seen while delivering to the tank? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. After removing the probe from the tank, it has been inspected and any damaged or missing parts replaced? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 6. Float moves freely on stem without binding? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 7. Moving product level float up the stem trigger alarm? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 8. Inch level from bottom of stem when 90% alarm is triggered? 40 1/2 9. Tank volume at inch level in Line 8. 507 10. Calculate (Line 9 / Line 1) X 100 89.89 11. Is line 10 less than 90%? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 12. Fuel float level on the console agrees with the gauge stick reading? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 13. Overfill alarm activates at any product level above 90% tank capacity? ☐Yes ☒No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No If any answers in Lines 3, 4, 5, 6, 7, or 11 are "No," or Line 13 is “Yes,” the system has failed the test. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Tester’s Name Taber DeHart, UT-0394 Tester’s Signature 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 801-261-4054 SPILL BUCKET INTEGRITY TESTING HYDROSTATIC TEST METHOD SINGLE- AND DOUBLE-WALLED VACUUM TEST METHOD Facility Name: St. Joseph Villa Owner: St. Joseph Villa Address: 451 East Bishop Federal Lane Address: 451 East Bishop Federal Lane City, State, Zip: Salt Lake City, Utah 84115 City, State, Zip: Salt Lake City, Utah 84115 Facility I.D.#: 4001703 Phone #: 385-266-2883 Testing Company: Westech Phone #: 801-266-2545 Date: 10/18/24 This procedure is to test the leak integrity of single- and double-walled spill buckets. See PEI/RP1200 Section 6.2 for hydrostatic test method, Section 6.3 for single-walled vacuum test method and Section 6.4 for double-walled vacuum test method. Tank Number 1 Product Stored DSL Spill Bucket Capacity 5-Gallon Manufacturer OPW Construction ☐Double-walled ☒Single-walled ☐Double-walled ☐Single-walled ☐Double-walled ☐Single-walled ☐Double-walled ☐Single-walled Test Type ☒Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☐Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☐Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☐Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled Spill Bucket Type ☒Product ☐Vapor ☐Product ☐Vapor ☐Product ☐Vapor ☐Product ☐Vapor Liquid and debris remove from spill bucket?* ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No Visual Inspection (no cracks, loose parts or separation of the bucket from the fill pipe.) ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No Tank Riser cap included in test? ☒Yes ☐No ☐NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA Drain valve included in test? ☒Yes ☐No ☐NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA Starting Level 8 7/8” Test Start Time 12:28 Ending Level 8 7/8” Test End Time 1:28 Test Period 1 Hour Level Change 0” Pass/fail criteria: Must pass visual inspection. Hydrostatic: Water level drop of less than 1/8 inch; Vacuum single-walled only: Maintain at least 26 inches water column; Vacuum double-walled: maintain at least 12 inches water column. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: *All liquids and debris must be disposed of properly Tester’s Name Taber DeHart, UT-0394 Tester’s Signature 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 801-261-4054 UST OVERFILL EQUIPMENT INSPECTION AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE Facility Name: St. Joseph Villa Owner: St. Joseph Villa Address: 451 East Bishop Federal Lane Address: 451 East Bishop Federal Lane City, State, Zip: Salt Lake City, Utah 84115 City, State, Zip: Salt Lake City, Utah 84115 Facility I.D.#: 4001703 Phone #: 385-266-2883 Testing Company: Westech Phone #: 801-266-2545 Date: 10/18/24 This data sheet is for inspecting automatic shutoff devices and ball float valve. See PEI/RP1200 Section 7 for inspection procedures. Product Grade DSL Tank Number 2 Tank Volume, gallons 543 Tank Diameter, inches 47 5/8” Overfill Prevention Device Brand OPW Type ☒ Automatic Shutoff Device ☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve AUTOMATIC SHUTOFF DEVICE INSPECTION 1. Drop tube removed from tank? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 2. Drop tube and float mechanisms free of debris? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 3. Float moves freely without binding and poppet moves into flow path? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Bypass valve in the drop tube open and free of blockage (if present)? ☒Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present 5. Flapper adjusted to shut off flow at 95% capacity? * ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No A "No" to any item in Lines 1-5 indicates a test failure. BALL FLOAT VALVE INSPECTION** 1. Tank top fitting vapor-tight and leak free? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 2. Ball float cage free of debris? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 3. Ball free of holes and cracks and moves freely in cage? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Vent hole in pipe open and near top of tank? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. Ball float pipe proper length to restrict flow to 90% capacity? *** ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No A "No" to any item in Lines 1-5 indicates a test failure. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: *Use manufacturer’s suggested procedure for determining if automatic shutoff device will shut off flow at 95% capacity. **If a ball float valve is found to fail the inspection, another method of overfill must be used. ***Use manufacturer’s suggested procedure for determining if flow restriction device will restrict flow at 90% capacity. Tester’s Name Taber DeHart, UT-0394 Tester’s Signature