DERR-2024-012779

Page 1 of_ Utah Department of Environmental Quality
APST Equipment Verification Inspection
Ownership of Tanks Location of Tanks
KILGORE COMPANIES , LLC KILGORE PAVING & MAINTENANCE
PO BOX869 7057 W 2100 S
4002421
MAGNA luT 184044 WEST VALLEY CITY luT 184128
Contact Name : #/Email : -
SPCC Plan?: ~e9 No I Last Fire Marshal lnsp : ATG Info:
Complete for each tank. # J/.i # I B # # # #
Capacity of tank (gallons): ~ IL. 4-1.(
Orientation of tank: U-nr ,· "7-D 11-l-t.1 l
Bottom of tank in contact with (soil,
gravel , concrete , not touching): -!Vnk I::. IO u r/h ,'.A""'
Substance stored : f)1',b5.,fJ,/ /'_ 1.2 _< I fMt.
Date last used/depth of product: ....
Type of spill prevention device: D," rfl111,-..t, ,J,_ W /~,d
Type of Piping (Pressure or Suction): p~~ <. C./Ai ,...p ~
Does pressure piping have LLD : Yes No-@ Yes No ~ Yes No NA Yes No NA Yes No NA Yes No NA
Spill bucket is clean, intact, etc .: fesJ No ~sJ No Yes No Yes No Yes No Yes No
Type of overfill Prevention device :
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified : Yes No NA
Pipe trans fle x protection method
5UrY\, 11 -.... (Sump , CP , Isolated, Booted):
Containment sumps dry : Yes ~o) NA Yes 11a) NA Yes No NA Yes No NA Yes No NA Yes No NA
~
Sump comments :
Stage 1 Vapor Recovery : 2pt Coax None_ 2pt _ Coax None 2pt Coax None 2pt Coax None 2pt Coax None 2pt Coax None
Pressure Vent Valve is on vents : Y~s No ¥AJ I tes) No NA Yes No NA Yes No NA Yes No NA Yes No NA
Secondary containment area -
comments: d,y
Complete for each dispenser # IP ? /2. # :Jll!ilp I # # # #
Flex protection method (UDC,
CA l'J G u () c,, Cathod ic Protection, Isolated , Booted):
UDC sump dry : '4ls <f'o) NA ~s ) No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored , located below ~ No NA v No NA Yes No NA Yes No NA Yes No NA Yes No NA
grade , and without ball valve :
Comments :
Additional dispenser questions # # # # # #
Flex protection method (UDC ,
Cathodic Protection , Isolated , Booted):
UDC sump dry: Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored , located below Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
grade, and no ball valve :
Comments :
Additional Comments : Financial Responsibility (State Use Only)
FR Method: r.1 ~ -,-l Method OK? l ~ No by: 5.&~'-./
Signatures
I ~ n ,.-1 h W ;J /)'\ er Inspected this facility on{:ilt./.:lA
Signz:1..P'AAA / (//a /Jt-,t?/ Tl
2/tf
0/0 Signature :
Attach Tank Info Sheet to Inspection with any edits .
Page2of_ Utah Department of Environmental Quality
APST Facility Site Plat ---
NORTH
2 loo .s ----------
i£J
f fl l
L:.. _:::..z I
,------------~------~,/
4002421
Show locations of all buildings, streets, tanks , piping, and dispenser islands. Indicate the product in each tank . Show locations of tank
manways and identify each : submersible pump (S), tank fill (F), ATG probe (A), interstitial probe (I), vapor recovery (V), capped plug (C), other
(specify). -----------------------Comments :