DERR-2024-012995

UNDERGROUND STORAGE TANK CLOSURE PLAN (rev. 7/13) FACILITY ID# _4000303 __
LHDUSEONLY STATE USE ONLY
Date Received Date Received
Date Mailed to LHD Reviewer Date Received From LHD Date LHD Anoroved Reviewer/Date Annroved Date mailed to State Mgr, Review/Date
Closure Plan prepared at the request of the owner/operator (identified below) by Trov Soackman
of ( company name) Spackman Entemrises I Phone# [phone]
Address P.O. Box 1276 I Citv Centerville l StateUT I Zip84014
A Contractor may prepare this Closure Plan as the owner/operator's agent. In preparing the Closure Plan, the Contractor must act with the owner/operator's knowledge and approval. The owner/operator must sign the Closure Plan. Submit Closure Plan to: DERR/UST,
P.O. Box 144840, Salt Lake City, Utah, 84114-4840
This Closure Plan is submitted in compliance with the requirements contained in 40 CFR 280 Subpart G and RJ 11-204 (U.A.C.)
FACILITY INFORMATION
Tank Owner State Fuel Network Phone# [phone]
\ Citv Taylorsville
State I Zip 84129 Address 4315 S 2700 W UT
Facility Name U of U Hospital AirMedHeliport
\ City Salt Lake State I Zip 84113 Address 50 No1ih Medical Drive UT
Contact person Brett Gurney Phone# [phone]
Total number of regulated underground tanks at this site 7
Total number ofregulated underground tanks at this site to be closed 1
Piping closure only O I Tank # 1
Tank Type (Steel,FRP,etc.) DWFRP Piping Type (Steel,FRP,etc.) DWFRP Date Installed 09/19/2001
Capacity 12000
Substance stored* Jet Fuel
Date last operated 12/30/2022
Removal/in Place/Change in In Place Service (ClS)?
*Tndicate the specific substance stored 111 each tank to be closed (gasolme, diesel, new 011, waste oil, etc.)
For waste oil tanks: Have degreasing or other types of solvents been stored or mixed with the waste oil?
Yes (identify ifknown) ____________________ No D NotKnown D
Analysis for lead or other contaminants may be required prior to disposal of contaminated soil or other material. (Check with your disposal facility.) 1 12/5/2024
12/5/2024
12/5/2024