DERR-2024-004981

The pnrnrr_v grryorc of rhir norifrcrtion profrn ir to hctrc rnd crtluarc uadar-trouno trnlr thtt rto.r or h.rc ltottd ,tt.oilum or lrrardos tutruts. li bcrpcctcd rhrr rhc rnfornrrion you prordc rrll b. bu.d "';ro.Uy a;aiilarrcordr. or. rn rhc rbrcrrc of rrrh rtc'ordr. yor tmrrcdlr-. bcrir, or ricnirc,oc- -
Wto llir Nodfy! Sccrroa tlt2 of I,CRA. .l .rrrcrjcd. ltqsrrci rtr.r. urrtr.erctnptcd. o-rtrfr oa u,rdcrt oond Unh thar ro't rElglrtC subdrrs murr naifvo..ran rcc sr.rc or-lcrr rtHErr of rha srurcilr ol rtrrr untr. orrn n*ril
--!., :1 ilt ctta ot !n uilrcrtnound {o.ra! llnl rn rr ol Norrnbrr l. ll{ c
:.::,TIl .'llo-,.*.{Er U.r d&r. .nI Frto.r ?ho otru.a uo.tcrt ound no.C ti,liu8o ror lic tlo'lE ur. or dllFataag of ltlulrrcd tlllnrrs" r-ndtut rn ltr clr oI tnv urtcrjrourtr $ollt3 ranl rn urc bfort llornricr t. lla.but no lonSer in rc an ritrr dlc. rny pcr:on ;fro orra rrrrr i* rmi;in H;tk driconnnutaron of ir rr.frht til! Ar hdd? Undc?3rourrd lont3 onl r dcfirrd D lny o.: orcombrntrtoa of rentt th.t t lt r rrcd io coaurn rn-s,rn uttr.6i-; -*-i]d;;
rumcr.-end (21 rio.c roaurE (rrrludiq colrrtcd u,tcrgo,rru aoriirr " ntmorc baari rtr ?osrr. So.ttr crunplcr-er uucnrornd n*inrli-nii irnrli-ur.{ orr. o? da6ca fcr. &d t rndrarial tolEntt. plrinrr hcrriridcr n tuinryrr.
W_b Tadt Ar Ert?.Trab r:rnottd fronr ilr jrorrra rlt noa st.cr ronortfic.lton. Olrt unlr crcludcd fiun acifgtroo erc: -
l. fenn or rtrrdcaul natr of l. l0 ;llbo c Is cepciry u*d for rrcinj rnoor fclfor mrrootnrrcrl purporcr:
i: llLli#_llt rorirq hcrtinlol forGmtulrFit rr oo tlE r.trrtr6 rl*rr rrocd:
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n:3.:::S6frr:!tildp ll'"fi,ltr .'.TEfmf i, [::nm: :!=:.ryI=lltlllt.rl .r h.ardosr rrrtt urrdcr Subrutc C of fCnr rr .r..:r"Esffi !['ffi *T"..fl mffi i;*t-1.;1ffi,v{rar! tlrlr aLoarrEl
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ltt To-ildf t. Orrrn 61 g1gjryq,r.rd \ro.ra! Enlr rn u!€ o, thar h.\ € bccro&'. ar of oF'.rroa rficr Jrn.rery r--r97t. ii"il iliil;i-.r,u. mu$ no(rt r 5rMry l. lllc. i Orra rho btr6. rnurr acry i.t .. tod.;xffiHfilHlH.Tl raro u:s rfrer Me1 i
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lndicttc numb6 of
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Frdl[ty tlnror Cornpeny Siit. tdcntitar. r..ppticrbb
Plcrsc rypc or pnnrin inl rll irerr crcpr .r[nluc- in Saim V. Tb hr ur b colH bG lcloo GclliltrDdcrt otn ! rc4: udr lf morr rhrn 5 onir rrc orrncd ir rn.r'toclrionpnor<ropl thc rErcttc adc. rnd ilflc@nrinulion rh-r rc rhb form.
N.rn (lt lrfll.lt Srrioo l.,nart bor ftf,t
Ted 0viar r
JoOTlt
Dlvislon Gasollne Manager
tr Mrrt bor hrr firy at thb b rn ftrtdd or.ub-qrmt rctillcruqr tc tha! roc.tion
Arrco(b Plp0ilunrb.t303 7 40-9333
O.bsign dr- /6- g6
l-99n'! yld'r q9^mlty olqw th.t I h.ro pcrrnally cHmincd.nd rrn hmilhr with 0r. intormetion $/bmin d in thir end rl rttachaddocumcnts, rnd th.t be13t on rny inqui4i ol thc'lndividrr.t imrn dnE y ,lrpo't. bb ildfifiing-01. il6;.1iii6; ii,cri""" rhar rh6submrtted intormltlon BtnJa, accirnti. anOcomplcf. ----
ZlPCcts.
Itrrt bor tren it hnr(31fltbcrUEOnlandwlthrn Fr
rn lndhn nraiv!fion or lJ
on othar lndian lru3t tandt
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SdrL-C.II. lXrraar6.@ APR 2 B 198
(Co.ro.trio. t,idavilra. a$aac egoacl. oof* Enrttyl
The Southland Corporation
StrQtAddr6a
7 167 S . Alron Way
countY Arapahoe
zlPcp,,.801r2
Arcr Codo Phqro Numbor303 740-9333
Typcof Ornr (tldrltulqt ll)
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Notification for Underground Storage Tanks STATE USE ONLY
Sam Agcrcy Nam ard Addms
Division of Environental Response and Remediation
150 Norttt 1950 West
Sdt Lake City, Uah 84116
ID NUMBER
)ooo (3K
TYPE OF NOTIFICATTON DArE RECETVED >lslqq
A. NEW FACILITY X B. AMENDED C. CLOSURE A. Date Enter€d inro Computer llJFl
B. Data Entry Clerk Initials P
C. Owner was Contacted to Clarify
Responses. Comments
3 No. of tanks at facility 0 No. of continuation sheets atached
INSTRUCIIONS
Please tvoe or orint in ink all items except "signaurre" in section V. This
form must be completed for each location ssaglining underground storage
tanks. Ifmore than five (5) anks are owned at this location, photocopy the
following sheets, and staple continuation sheets to the form.
Ndifietioo is required by Fc&rat l3w fa all un&rgrond trnls thar haw beetr
Brd to 3ttre rcgular€d substares sire rilwy l, 194, rhar uc in thc grdnd s of
May E, 19E6, q dnt ile brqrght imo ue after May 8, 1986. Thc infumtion
requted is rcquired by Serion 90@ of the Rcsue Coroemtion ard R@very Act,
(RCRA), u mendcd.
Thc primry purpoce of this rDtifietion progru is !o lmtc ard eElutc
undergrutd lanls that sttre tr harc stqcd pctdem a haadou substaEs. It is
c)pccEd oEt drc infrnution 1ur pmidc will be based m Hombly aEilable rffids,
tr in tlE &b6rre of sEh rffi&, pur lorowledgc, belief, tr mlletion.
Who Mwt NotiBf Soctiotr 9m2 of RCRA, r mnded, requirc that unles
cxempted ryrcrs of udffgmnd tanks that sttre rcgulated substams mut motiry
dqsigEted State fi lcd agercis of thc existarce of their anks. eypl 6-
a) in the 6e of il udergrsnd sbrage tank in ue on Nmmber E, !9t4,
a brught into uc after that dab, ily penon who wrc u undergmnd
sttrage tatrk 6cd ftr tlE stoEgc, ue, u dipcring of rcgulated
substares, ard
b) in the rue of my urdergrond storage tatrk in ue befw Nwember g,
19t4, but rc longer k ue on thal date, uy person who wned srch tank
immediately beftre tlE disotrtinution of its ae,c) if the State agercy so require, my facility rhat hil undcrgorc uy
changs to frcility inftrmtion tr tank sysrem status (only mrded tank
infqmtim meds o bc irchded).
Whar Tanb Are LEluded? Undcrgrord storage tank is dcfined a uy orc tr
@mbimtion of anls that (l) is ued to milain u euulation of .regulaed
subsam,' and @) wlme wlum (irclding mImted urdergund piping) is 10% tr
me bcmth the ground. Some empl* rc undergroud tanb sttring:
l. g8oliE, ued oil, tr disel fiEl, altd
2. iduEial solreil!, Fsticids, herbicid$ c fumigails.
What Tanls Are Ercluded? Tanb rcnrrcd &om the grond [c rDt subjEt to
rnifmtim. other ark ercludcd from ruifietion re:
l. hrm c rsidential t8nh of l,lm galloN q lBs capscity ued fq stning
mtor fipl ftr mmmmilcial purposs;
2. tanlc ued for sloring haaing oil fq @mumptive [e on the premiso
wh€r€ sttred;
3. septic ada;
4. pipelir fcilitiB (irclding gathering lim) regulatcd urder ahc Nanral
cB Pipclirc Safety Act of 196t, u the Haadous Liquid pipcliE Safcty
Act of 1yr9, fi which is u iErstaE pipclirc facility regulaEd undcr StrE
laws;
5. sufae impoudrenb, pirs, pords, u lagore;
6. stfim watrr fr wte mter olledon stBtcm;
7. flw-thrugh ms tank;
8. liquid traps r rsaiated gatherirg lirc dirctly rclat€d to oil tr ga
prodrction and gathering qeation;
9. strage anls situatcd in u urdergrund ilE (srch I a bserent, ellu,
mircwrking, drift, shaft, n tuml) if 0rc sffiagc EDk is situated upon n
above the sufae of the flor.
What Subsrares Are Crered? The mtifierion rcquiremcnE appty to undcr grmnd
sttrege tanls that ontain reguletrd substalB. This ircldcs my sub8tam dcfiEd a
hadors in setion l0l Q4) of tlrc ConprehcEirc Ewiromild RsIDEc,
Comperatioo ard Liability Acr of 19tO (CERCLA), with rhc ereption of rhse
subsam rcgulared r haadru mtcr urd€r Subtitlc C of RCRA. It slso irclude
pcEolcm, e.g. cnde oil fi uy frrction thermf which b tiquid at statrdrd @diaioB of
tcmperatue ard prusue (60 degres Fafuenheit and 14.7 poutds per sqwe irch
absoluto).
Where b Notiti? Scrd omplcted fcm tor
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF EWIRONMEMAL RESPONSE
I6t NORTH I9'O WEST IST FLOOR
SALT LAKE CITY, I'TAH t4II6
When To Notiff?
1. Owrers of undcrgrond stqage tanh in uc or that haw been t ken ut of
eention after Jmury l, lr4, but still in dE grond, mut ruify by
MayE, l .
2. Owrcrc who brirE urdcrgrerd stqagc tan&s iilo wc after May t, 19g6,
mut rDtify within 30 days of bringiry the tatrb into e.3. If th€ Statr requirB rctifietion of uy mndmnts to faciltiy scnd
infqmtion ro Snr agercy imn€diately,
Pelrlti6! Any owrer who kwingly fails to notiry or submits false infcmtion
shall be subjet to a civil p€mlty rrt to ex@d $10,0ff) for oh tank fc which
mtifietiotr is rDt giren c for which h.lrc irfcmtion i! lubmitr€d.
rr. LocATroN OF TANK(S)I. OWNERSHIP OF TANK(S)
EPA Form 7530-l (Rev.2-92)
M. TYPE OF OWNER TV. INDIAN LANDS
_ Federal Government X Commercial
_ Stato Government _ Private
_ Local Govemment
Tanks are located on land widrin an Indian
Reservation or on other trust lands.
Tanks are owned by native American nation,
tribe, or individual.
Tribe or Namtion:
V. TYPE OF FACILITY
Select the Appropriate Facility Description
X Gas Station
_ Petroleum Distributor
_ Air Taxi (Airline)
_ Aircraft Owner
_ Auto Dealership
_ Railroad
_ Federal - Non-Military
_ Federal - Miliary
_ Industrial
Contractor
_ Tnrcking/Tramport
_ Utilities
_ Residential
_ Famr
_ Other (Explain)
VI. CONTACT PERSON IN CHARGE OF TANKS
Name
Bud Good
Address Phone Number
7167 So. Alton Way, Englewood, CO (303)7&-9333
Job Title
Environemtnal Mgr.
Vtr. FINANCIAL RESPONSIBILITY
Sate Funds
Trust Fund
Other Method Allowed Speciff
Check All that Apply
X Self Insurance
Commercial Insurance
Risk Retention Group
I have met the financial rcsponsibility requirements in accordance with 40 CFR Subpart H YES
! Guaranteet-
It^i _ Surety Bond
I
II X Letter of Crcdit
VItr. CERTIFICATION (Read and sign after completing all sections)
I certify under penalty of law that I have personally examined and am familiar with the information submitted in this and all auached
documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that the
submined information is true, accurate, and complete.
Name and official title of owner ot owners
authorized representative (Print)
Shelly A. McMurtrey
Signature
-,u,10"hx01l o,irt^,r
Date Signed
al-lqa
Paperwork Reduction\A,ct Notice '\ t \
EPA estimates public reporting burden for this form to average 30 minutes per response including time for reviewing instruction,
gatheing and mainaining the data needed and completing and reviewing the form. Send comments regarding this burden estimate to
Chief, Information Policy Branch PM-223, U.S. Environmental Protection Agency, 4Ol M Street, Washington D.C. 20460, marked
"Attention Desk Offrcer for EPA. " This form amends the previous notification form as printed in ,lO CFR Part 280, Appendix I.
Previous editions of this notification form may be used while supplies last.
D(. DESCRIPTION OF UNDERGROUND STORAGE TANKS (Complete for each tank at this location.)
Tank ldentification Number Tank No. I Tank No. 2 Tank No. 3 Tank No.Tank No.
l. Status of Tank (mark only one)
Currently in Use
Temporarily Out of Use
(Remmber to fill0t stiotr X)
Permanently Out of Use
(Remmber o fill out setion X)
Amendment of lnformation
x x x
2. Dard- of Installation (mo./year)1984 1984 r984
3. Estimated Total Capacity Gallons)10.m0 10.000 10.000
4. Material of Construction
(Mark all that apply)
Asphalt Coated or Bare Steel
Cathodically Protected Steel
Epoxy Coated Steel
Composite (Sterl with Fiberglass)
Fiberglass Reinforced Plastic
Lined Interior
Double lYalled
Polyethylene Tank lacket
Concrete
Excavaton Liner
Unkown
Other, Please specciff
Has tank been repaired?
x x x
NO NO NO
5, Piping Material (Mark all that
applv)
Bare Steel
Galvanized Steel
Fiberglass Reinforced Plastic
Copper
Cathodically Protected
Double Walled
Secondary Containment
Undnown
Other, Please Specify
x x x
6. Piping Tlpe (Mark all that apply)
Suction: ,o vdvs 6t rank
Suction: valve at tank
Pressure
Gravity Feed
Has piping been repaired?
x x x
NO NO NO
Tank Identification Number Tank No. I Tank No. 2 Tank No. 3 Tank No.Tank No.
7. Substance Currently or Iast Stored
in Greatest Quantity by Volume
Gasoline
Diesel
Gasohol
Kerosene
Heating Oil
Used Oil
Other, Please Speci$
x x x
Hazardous Subsance
CERCLA name and/or, CAS number
Mixurre of Substances
Please Specify
X. TANKS OUT OF USE, OR CHANGE IN SERVICE
1. Closing of Tank
A. Estimated date last used
(mo./day/year)
B, Estimate date f4nk closed
(mo./day/year)
C. Tank was removed ftom
ground
D. Tank was closed in
ground
E. Tank filled with inert
material
Describe:
F. Change in service
2. Site Assessment Completed
Evidence of a leak detected
OATH: I certifr the information conceming installation that is prov in section XI is tnre to the best of my belief and knowledge.
2--t-94
Name
Installer:
P.E.S.I.
2440 South 3270 West
Salt Lake City, UT 84119
Po Company
XI. CERTIFICATION OF COMPLIANCE (COMPLETE FOR ALL NEW AND UPGRADED TANKS AT THIS LOCATION)
1. lnstalltion
A. Installer certified by tank and
piping manufacurres
B. Insaller Certified or licensed
by the implementing agency
C. Installation inspected by a
registered engineer
D. Insallation inspected and
approved by implementing
agency
E. Manufacurrer's installation
checkliss have been completed
F. Another method allowed by
State agency. Please specifu.
YES
YES
YES
YES
YES
YES
YES
YES
YES
TANK
x
x
x
x
x
x
:
PIPING
_r_x
x
x
x
x
x_r__r_
PIPING
x
x
TANK
x_r__r__r___r_x_r_
PIPING
x
x
TANK PIPING TANK PIPING2. Release Detection (Mark all that
aPPIY)
A. Manual ank gauging
B. Tank tightress testing
C. Inventory Control
D. Automatic ank gauging
E. Vapor monitoring
F. Groundwater monitoring
G. Intentital monitoring double
walled ail/piping
H. Intersital monitoring/secondary
containment
I. Automatic line leak deteclors
J. Line tightness testing
K. Other method allowed by
knplementing Agency.
Please speciS.
3. Spill and Overfill Protecfion
A. Overfill device installed
B. Spill device installed.
EPA Form 7530-l (Rev. 2-92)
UST Installation/Upgrade Notification L -. r.: fi f\I r r,r .J .j i.... ,
The Utah Underground Storage Tank (UST) rules (Utah Administrative Code R311-203-3) require that UST Insallers notifu the Executive
Secreary, Utah Solid and Hazardous Waste Control Board, 30 days before insalling or upgrading any regirldted UST system. This form
has been prcpared to assist you in providing this information. Before insalling or upgrading an UST system, please complete this forrn and
return it to the Division of Environmental Response and Remediation at the address below. If any tanks or lines are rcmoved or replaced, a
Closure Plan for those tanks or lines must be zubmitted and approved, and a site assessment must be performed at closure.
Facility ID# (if not a new facility)2000138 [ ] New Installation I X ]Upgrade
Date work will commence N/A
Tank Orvner The Southland Corporation Phone #(303) 7'10-9333
Address 7167 Souttr Alton Wav Ciry Enslewood State_lJI_ Zip_80llz-
re;'tl Z ;S'^ha!
<tlr la-
zod! t ,8'
T7.riN u'tl at':\
Contactperson Budcood Phone#(303)_@[
Facility Name_7-Eleven
Address 17 East Main Street City Delta SaE_UT_ Zip_?A(a4_
Contact Person Bud Good Phone #(303) 7,+0-933
Certilied Tank Installer Nsme Cert. #TL Exp. date_
Company Phone #( )
State_ Zip-Address Ctty
Instatlation/Llpgrade Infonnation
Tank #
Install/Upgrade
Capacity (gallons)
Type (FRP, Steel, erc.)
Substance to be stored
Piping Type (Press., Suction, Gravity)
Tank Leak Detection method
Line leak detection method
Form of Corrosion Protection
Spill device to be installed (Y/N)
Overfill device to be instaUed (Y/N)
Unusual or extenuating circumstances
#l
Upgrade
10.000
STI-P3
Fuel
Press.
AGTS
PLD
Y
Y
#2 #3
Uosrade Usrade
10.000 10.000
STI.I3 STI-P3
Fuel Fuel
Press. Press.
ATGS ATGS
PLD PLD
nla nla
YY
YY
NONEexpected:
xt CERTlFlc TlOltl OF COMP. .{cE (OOIIPIETE FOR ALI- NEW Al.lD UFGR_jO TA}116 AT THIS trOCATlof.l}
Trnk Hcndlicatbn Nun$er
1. h$elstbn
A" hslaller ccrtficd b, tad( ad
pphg manurdurtr!
B. hdellcr ertlllcd or llacns.d b, th.
lnplementirp recncy
C. httallatlon laspected by a
nglctemd enginccr
D. hstalldion lnspected end
appoved by Lnplemenfing agency
E. llanuradurer,s lndelhbn cired<-
lgts hslre bcen ompleted
F. Anoher method a[oured by Statc
agency. Please spcify.
2 Release Deteciion (Malk allihat apply)
A Manualtankgauglng
B. Tank tightn€ss testing
C. lnventory onfob
D. Aubmdic tenk gauging
E" Vapor monitoring
F. Grcundwater montodng
G. lnterstitial monltoring.double wailed
tank&birU
H. lnterstiti,al monltorirqileecondary
containment
l. Aubmatic line leakdctccbn
J. Lhc tightness tcsdng
K other method atlowed by
lmplementing Agency. Ftease
spedty.
TAT{K
EwfltlflEErl
E
fl
PIPIT{G
tlEE
tl
wwE
TAIIK
WwrflflEfl
tl
fl
E
flEfl
E
w
EEE
E
wwE
TAI{K
EflfltlEtlE
E
E
fl
PFllrlc
tlEE
E
flfltl
3. SpIl and Overlill Prd.dbn
A Ovcrfill device installed
B. Spllldevicc turefl.d
Prgo 5
XofItcrtlo b iCsH t, A.r.l li la dl rr.a.{Ei.a l.nf. lll.1
h.rt t-o u..d to tcr rrgrdat.a auiarE ar.E .Erory t. tfa, Gat
.,r an ti. eJu.la r d Ir, 4. tlla, ll- rt ruiil hb lI. dl, Lr a.tt5. Th. Hattirbl oqrlaed b rtlrti !, 6.cb.r !E C orr irour
Conr.r.a5.r .,rd Brcrry fa. tnCn$ r frra-.
Tha omr.ry 9.rf. oa ni rEdfur !.Sr]lr G D tsco and adro
un(rrlrqrn<, anL lrat aE'a oa iava aEao oat laJm ot Lilrr,Eta StElllrEL
li E etrq.o lrrto. mlo,ttraErtq, o.wlr.H r Groa r-:5trr!i,
.v.i.Db rtcD,G. s n lla aEr.Er o, iEr ,.GsE yor rrrrogr. trr[ or
ra(oll-ErL
Who L.r.l llo0rn Srctof,El oIRCRA ruraa.rE irrhd.u{-
crarnB-, ilnirt of urEa.lrurd rrur hal aEa ,telltat ]at!Itc- lttlrrl
rloly daee llr- Stla o. ld {rtor ol Gr rrsu O Oa, ants Orrtm-rr-
.l h rh. crr. ol .rr uldallurrd aEQt llt h rr an l|ililf a. teOf . abudr hE l...rE l! (Ia. flt P.rr rl! frr rt orcgruri.Enea
Enf ll.d b? lta.D.!o. lr. d dir.ft9 cl r?,oC rltsrrE art
bl h 6. c!l. d.rr, rri.Arurd.Etea rrr n t.. tba l{orilr a.
198a. hJl rD b.!r a C. Or th.li5 rt, FEr fir d aJCh rrt
mm.d..|, babr Ga dcarlnltEn C aa lI .
cr arth. Sfr.el.laro r*ir ]ty Sny,t!i- ur5.Oqr..rV Cutg-
b ldiv hbil.a.ro a rt.F..ll E 3 (artr ut E anr nlxtrrEo rcbbrclstd).
Wtd frab l,r hclrdrd? tltrBurd 3De. ril a d.,H - rt' ar.r can!.taEr o, Et ,ta! (tr a l,.rl ! crrrla rr a.Eri.ltci ot 'iaeuLE..Jd3.rr.'.ri (a rlr tlftt. (naft orlad rdrttqrS lii.tel at6f a nro.r ba.rth n Gcad, 8oll. I.tncb.rt t cularn llts aEitg:
1. G.D51 u...!d. 6 d-a t .t rx, 2. iddr rcf,!. l-E.-,h.rod.hafuni,tlE
SIr frafr !r €rCu{d? Tl5 riou- tsi
'I,C,E
dr. nd3rq.q
o mthrn Olr Iilt rcld toltt iofrEr.,l:
l. lrtl a rri,.tad tnEol t.ro Fb.rs r..tFot lI- bEt,[
moEr t .l ba rErD.tuna6j lU'fi
e anL utd b aEUtC I!I!E ca b. qrrnFr .3 or il gur-
rr!|taDr'Il:
Form Approv.d. OltB No. 2050{r06t. Approvrl .rplt . tr3t/95
t a.farr..:
a. t r,.ai. hc*d- aagrfic c.nrhe lbt r.er-ad l,r- rr. ltr,ld 6G
Pira'r S.hryrcd r$4. o, G. llrrrlrrl.tilrd Pir.aa!. s.r.(,ldc ter9. c,
#r a tr hlrril. gdr gty rgifC ui.. SEr trs
5. ar5.ttEltctr.Ja. r!r. Frc. c LFt
C taar! f, r r rGa rU dbcEr q,laitt
7.tl*orol{hp.rrrt :
a. fiqri lrr d arG.t- ealr.flre lir fcly rabrad D oa a 0a3
Farclar rxt eflamg gilErr:
t. E {. lrll3!.rd n an ur!a,g.ul.n ar- (3.rdr ar a blLttxll Gr3.
rnirEtire[ ari.:rdf s unro il nr aa.ea rrt a.rlra uFlta.E! !r
rlrllc. o, dr. ia..
ftt &*arrE &r Co(t.td? llr mrficrrn rqirrrra.ld, D urE,
lrc'ld o.sa art n taDnan arfffi 3h,E. Ih3 ind.dr ny
a.E E otr5.. llrt]IE! h.@r tot (ta) o, .t. c.nrldrfax'
E nigtn-- nrF.r.. Gorrui,r rad taErt^dol llo GERCTAL rra
fu rcEr ol !E rEa,rqddr llriar r- afif
rc8^ i.:o itcfd- tsoot rtl...el. orra ol c rry t-in fu.E d*,r -Iqi'.t.ltllt drdtr C tnrPrlrr.t trd F-rt (CO Orgr Frtrrrr
]rO t.1.7 gqrc F...im hCr aLll,aL
Slrr Iollaly? Srr.' stlC.tsbttl.Ei
DEPARTMENT OF E}IVIRONMENfAL QUAUTY
DMSION OF E}MR,ONMENTAL REIIPONSE
t6t NoRTH 1950 WEST IST Fl,loR
SALT IAXE CITY. UTAII 8'lt 16
wlri L Ldtft t. frn r ol uodauurd E er rr5 h lr. c tfii lr.r.
b.ar af.a c,r d oF rr dufnt, t. l t a. but ad h tr $urt' ilr tEff
!t L, a. t $a Z Oiltil rfD li[ sttrgut 3Dlter r*. irD c..1, 5
1 t3a iln.tollr*titlaFC !hdt! tr trllr r.rt' t I n SD
,rqr- rEnbtln ol u; r.rnrrcn..E3 D btty aa.n hbltndt o srr 4rr1i/l,/tfrl.
Fmdrli: ln, crrtr &tcl4ty ldf 5 aollly s r..*,-lJar*r -rt t r,q- 5.dl Fllit tt lo.E .a tt0,ocb.drtd lcrfr&.r ic!lcr6. b d Clir t l!,rrr&i rrbr lds-h 5
.arl*54
Notification for Underground Storage Tanks
- 7 No. ol tanks A tacjlity
-
No. ol contruation stle€ts 8ttadled
A. Date Entered lnto Conpurer
8. Data EnEy Clert lnitids
C. O*ner Was ConEcted b
Claify Responsss. C6mments
Please tlrpe o? 6rint in ink e[ ltenr rrcepl 'dgnstr.'ln seairn V. This lorm
rrust be comCetd lor r.dr locrtin anlining wdeqrund 3b.sga tar{c. l,
rtre than fve (5) tarkr lre own.d rt fi3 bcaton. photapy the bllotriq
sheets, and staplc contiru.tioo shedr to Gr lornr.
l. OWNERSHIP oFTAITIK(S) II.LOCATpNOFTANK(SI
Qlrrra.,D (CcFilE\ E-Urd, P{tr19:r7, r O,: hft
C5-8.drrlrrrtn I I
*lllr-r--rrrEa- E-LEveN -SzPf # ZS o Bo
-..8r?.o,hrAqI'I EAST MAIN
-DrLrla Hr 6-
EPA Form 753Gt (8.% 2.92)
@ e,itwon?*tctedPaw
III. TT?E OF qI'TtEF tv.
tr F.nrrcorrnnrrl (cnt r-al
tr stelrGovrrul:ra El P*ao
tr locdGorrnr:tt
Tearr er rocar al lrrr trtil gr rdrr
Rurvabraqrorttrtnrsrlru. lJ
TartrrnorrrjtsYnrtiwArri:en Ft
ndirr. hbr. or rrivitrel. s
TtibqNain:
v.TY?EOFF C!.lw
-AtTrdGftr.)
-AtcrJtOrlr
-&rsOfath
Rrddrt0d
Frnr
crh,
S.ad0t AFroPilt F.dlYtEP|iIr
-Gas
St iqr
-Relrcad
-Frdrd-1fl|ry;HrslEl
_ConuEE
_frudin/fmsport
-Prtohrn
BiAIE
-F-d'ilsrfflry -tlltiD.)L
vt COltlTAfiPEHltOill lN C}IARGE OFT IIIKS
ArErr
62{/a N' a^relHt NGTG!.1
DE$veP CB 8o Z t 6
Nrnr
ftrclf F-ooTE
JobIIh
fv\srNTArlc€'
Supee V,SaQ
Plsr ltlrrir (H0AtrrGdlt-r
/ - 8ao -4to- 5.+ 6,:F
VII. FIMNCI^L BESPC'NSBIUTY
chdrroiAfct
I vl Sd harrrp
l-1 GoarrnrdJru .r t-l snryodd
I {963616
l-]rruan ro
t-lou.r mtodArdsP.d,
I llur rrtlrr lhrdd reecu&ny rt firnroBhsdruriltroCFBSttprlH
Vllt CEIIIFICAflC{ G.d.n dgn rrlr @lt?a-le d 1d..11
il-,r--.an"*nn rh'prrcrrlycrentrrdrErnrlrnflr.{trotHcnr&rennJtEhttrrtdrrddL'l(hm:13 rn 11n Dsd ; Afisefrni frvunf t rmaCy rrynrl* 6r ourilrg trr hEnrdbn l b.fd. Oi o'
gtrilLdHanndm btrrrrrre. lf oadrf.
lLJhrldffiJGodaraorr-trffinPcadrPttttl
Az,t ^ Sia.Pp*etANPadQ
rAr rrrrEDr t DFID
SflnR+s.,j
OOSlend
to /z3lq f
Prprrort Brducilton Act llotla.
EPArdnaaFrblc'teorllststtltttlt !rmb.1.ns.po+rff:,fgS:-:tff-lPgtSXillgg:iIffi'II' ^:1fggg1[l*H3",lggo"effi 'oi M-su'tt'1v1g';g1n*c:2:;311fg\raatrla IISla5l ruD,.Afrmton trd( oillc!, ta EpA..THc
'onn
.''Irld3 ili,aubut nffiiad tmir'ar prm.d h ao cFR Pert zso. APg.ndr t PnUir,s
.dlqt d thlr noticetoo En nuy bo urrd ufiflr 3tlpp0- hr-
EPA Fon! 713S1 (8.r. 2't2l 42
tx. DEscRtprtoN oF uruoenanouNo SToRAGE TANKS (@mfletc lor edr tank a tlls lGaion.l
tantr tto. t TarJr No. -Z Tank No. B Tar{r No'
-
Tanlr No'
-GrTlll'-T-1. Stanrs ol Tank(ffim(odyono) Curendyin
- PermanendY Out ol Use
t-aar-rl
Anrndmsrt ol lntormation
Tenporadly otrt ol Use
2. Dat ol hstdldion (!D/Ye.rl
3. EslinaodTotal CapanY $dlons)
4. Matenal o, ConstrucUcn
(iilark dl thd apply)
AsPhall Coated or Bare Steel
CatlrcticallY Rotocted Sle el
EPoxY Coat€d Steel
Conpo3ite (Sted $th Fibergie$!
Fiberglass Reinlorced Pt astic
tined lntenor
Oouble Walled
Polyethy'ene Tank Jad(st
Cfi€reta
Excavafiqr Uner
Ud(,lom
OOrr. Pleege rPecitY
Hes tank been rePaired?
ll
NSlh,LlrD N&lNsfau.at) NAorre$g&s.
@r*wr-
IN}TALLOL N€!o,sPAlmc-ry
(Mart eI thal apply) Ban Steel
Galvanizd Steel
Fiberglass Reinlorcad Plastic
CoPPer
CalhodcClY Prctded
, M.Wdd
Sccondery Gontdrunent
l-l
6.PtpmSfiyF)(ilrt d $el epdy,
Has pip&s been repeired? | l-l I f-l
EPA Forn 753&1 (Ba. 2'921
Tank No-Tanlr l{o.
-7. glbslanco C{rroalry or Lrsl Sllorrd
ln Gredct Ou.rilityby Vdunr
Gasolhc
Diesel
Gasohol
Kecosene
- Heaing Oil
Used O!
Otter, Ploase sPdfy
ru
I-t
l-l_:_
I
l-lt-
Hazardous SubstetP
CERCI.Angm alrdlot,
CAS number
fl
Mxture ol Substancas
Please speoty
X.TANKS OUT OF USE. OR C}IANGE IN SERVICE
1. Cbsing olTsnk
A Eslimaled dale last used
Fotdcrytyesl
B. Eslimate dat lslrkdos€d
lnr.tda,ylyerlN-
C. Tanlr was rclrulod lrcm gralnd
O. Tar*wasdeodlngnmd
E Tank fill.d rruilh hrl mduial
Describe
F. Changc ln rrvicr
2 Siite Arscsrrrnt Comdd.d
Evihncr ol a leel drlrdod rl
I
EP Fottn 7530.1 leer. 2A2l Frera
\
@NEw AND upcRAoED TAlrKsATTHrs LocATroN)
Tank ldentifrcaton Nurter Tar* No. I TanlrNo--?:Tanlr No. L Tank No.
-
Tank No.
1. lnstdlaion
A. lnstaller certilied rytank and
- piphg manulacturss
B. lnsuller crrlifed or licensed by the
imCemermng agency
C. lnstallatim inspeaed by a
regasterqt e.€ancr
D. lnsullatior inspeded and
approved by irplenrnung agorlcY
E. Manufa.n ers installalbn
dl€ddists haw been completed
F. Another me6od alk ured by State
agrrcy. Ptease spafy.
2. Release Oetecton (Mart all that apply)
A. Manuallankgaugir{,
B. Tank tightne$ testing
C. lnv€ntory control3
D. Aubmalic tank garrgang
E Vaporrnnitaiqg
F. Grq,ndraer rmr*toring
G. lnterstilial nroritorinE double wdled
tanVpiing
H. lnterstitial monitaing/secondary
containnEnl
1. Aubmatic tine lesl det€clors
J. Une tightness tesdng
K. Clfierm0ndallomdby
lnpl.m€flting Agency. Please
seedty.
TANK
EtrEEtlEE
E
G
E
TANK
EEEEEtln
E
B
tl
PIPING
tltlE
E
EBE
TANK
EEEEtlfltl
L]g
tl
PIPING
tEE
al
EgE
TANK
EtlEtlEtlE
E
E
E
TA}IK
EEEEEEE
E
E
tl
PIPING
EEtl
t:]EE
fI
PIPING
EEE
E
EgE
EEE
tlEE
E
3. Spitl andOverfil heclim
A. Ov€rfll dEYice hstall.d
B. Spll device innaflod
OATH: I c..tly th. hbrmdon otrmfing instellaton thn ir povkled h rccJon Xl ls
lnrtsllcr:
bclcl rnd fnowtodgc.
10-)?^ !(',
EPA Fonn 7530-t lR.r. 2421 Prgr5
,'or Usc Wiitr
o^,r--11.2!K-
h*r-D
t Saa.lq
--,ry,E brrtHbt.E
. $A:,Ot ro,l l(0t
a rtl lqt rart torqr^({ wrttr trrt trlt t(irt
rt rot{trr I{.({ U{r Il! tlrlro I
l, toa n/ r(Zt tnrr(rrv^lllUttlrt trvrt.rtu{I,*1rttrri, ttC
Bur:
5{t. t{,6rrr rf € tr t14, t,rtxfrd,ltlaricJoaElll4rl l{r4E eo C(u{rl i
.5;d'd"Tilff&*,s.
Aps*+$a &aO ga<t- I . c? 2?t
n i.; :tt t**nJ SgJ rn'-.u}]s -
5b'J'fa( 5F$/( Wt),-
ftrr*r4,i Bunf 3*el;'a? 6
I
cqfl/,os-o
o!,-
, Ar{
rtsl Rfguurs
0o'E" 7v7 igud lad
AWa**wFl'd &+(L=' o?sb
"/ q^:rh.
;hs
rffiO ,
t'
L lql I
1t d+! ;So
,r!_l o
tk_
4B
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6b_
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EE =5Vd
3NT )lllv!,,t qTD/ 68'IfiBI
'IE
:86 g6E T /EB i T I
ZwtBl
RECEIVED
sEP r S 2003
f,l''',r*y *r'rriR, & Remediation
September 9, 2003
Mr. William Moore
State of Utah DERR
168 North 1950 West
Salt Lake City, UT 84116
RE: Leak Detection Method
Dear Mr. Moore:
Effective with this notice 7-Eleven, lnc. is changing the method of leak detection
at severa! of our sites from Statistical lnventory Reconciliation (SlR) to
Continuous Statistical Leak Detection (CSLD) using the Veederoot TLS-350.
Enclosed are updated 7530 forms for the following sites:
7-Eleven Store #Address Citv
25030 17 East Main St.Delta
should you have any questions please feel free to call me (2s3) 796-7120.
Sincerely,
Randy Martin a <)
---.1
E nvi ro n menta[1M a n ager
BD:rr
Environmental Services Department / 1o22oJ*"mftt;rg Road, Suite 470 / portland,, oregon97223
9EPA unn€d stiates
Environmental Protestion Agency
Washington, DC 20460
STATE USE ONLY
Form ArrprovgO.
OMB Ito.2OSO-0068
Notification for Underground Storage Tanks
ID NIJIITIBER:
RECEIVEO:
DATE ENTERED INTO COMPUTER:
DATA ENTRY CLERK INITIALS:
OWNER WAS CONTACTED TO CTABIFY RESPONSES, COi,MENTS:
Q rrnon. ,.,-&*t Ahhn-
Number o, conlinualion sheots attach€d
Pl€as€ lpsgl enn!.in
'nlL.
Abo, be suro ypu harre Sgnatrres h ink ror s6c{ionsvilr.and x. Complete a nolitcalbn lbm for eacfr bca&rn ontainirB
undergrouncr storags tanks. lf nrore than 5 tanks are owned at this 6ca&rn, youmay photocopy pagss 3 flrough S and use them br adcf,tional hnks.
The primary purpose ot this notificalion prograrn is tc locate and waluate
llf€oynO stoEg€ tank systems (USTs) that slore or have storBct petroteum
or hr"ardous substances. The infomalion lrou provido wifi Oe OaseO onreasonably availabl€ re@rds, or in lhe aDsgnce of such r€conls, your
knowledge or recoll€ction.
F.ederal law reguircs usr ownere to u"e rfirs nottffcation rorm fror art
yl_T_" "t91lg regulated substance3-that are brought lnto uae atter-iiay O,
19991* USTs in rhe ground as ot t{ay 8, i!r86 thi have sbrcd regubied'lubatancca at eny Ome sinct.lanua4i l, 1974. The lnlormation -
ruquested ls rlggird by Secdon gOOa ot lhe Rssource Cons€ryation andRocoveiy Asi (FCRA), a! a,nencld.
Wlrc Must Notity ?Section 9OO2 ot RCRA, as amended, reguires owners ofy.STs ttat stgre reguhted substarces (unless exempteOl io nofify OeSgn"tJstate or local ag€ncies of the exstencd' of their USTi. 6rrner is d€nned as:
' ln the cass of an usr in us€ on t{o/ernb€r g, 1gg4, or bought into rrse arterqat da!e: any person who owns an UST us€d lor storag€, use, or dispensangof regulated subslances; or
' ln the case of an UST in use before November g, 1g&4. bur no ronger in use
qn thatdate, arry p€Bon who oum€d the UST immediately Oelore G
discontinuation.
Also' if the stale_T requires, any iacirity hat has made any ctranges to fiacirrtyintorm?tgl or UST system statris, mujt submit a notifica06n foriionfy -- -'
amended intnrmation needs to b€ indud€d).
What USTs Are lncluded ?An UST ryslem is defined as any one orcombinaton of tar* tr'"t (1) rs us€d to iontiain an acc,muratdr otiegurareosubstances, and (2) whos€ votume_(indLding connected unOerground rpingl is1fflo or morc beneath the grurnd. Reguhted USTs soie peforcum orhe"erdous substances (see the lollowing "vvhat SuOsfandes,Cre Covered).
WhatTanl€ Art E(cludcd Frpm Noliricaton ?. Iar{c r€fliov€d frcm tre gotnd bdorc May A, t9B6;' Farm or osidenlial tanks6f t,too gattons o',r, ress capacity sto.ing motor fuel tornoncomme,cial purposes;. Ianlc stonng h€aling oil tor use on he premises where stnred;. Seplic tanks;' Pip€line tacilit€s (induding gathe.ing rines) reguraled und€rth€ Naturar Gas
1!11ne sabv Act ot 1969, orthe Hazardous uqrid pip€line Safety Acl ol1979, cr ufii{*. is an inhaiate pipetine fadlity ,egirtateOt nOer Stad aG;. $rrlace impoundments, prS, ponAs, or tago6ns;-. $tcrm waterorwaste waiercittection q6[ems;. Fbw-thougrh pmcess tanks;' Lipid faps or associat€d gratremg lnes direcily related to oil or gas produclion
and gath€rhg operalbns;. Tanks on or ebove th€ ioor of und€€rcund areas, sncfi as bas€rnenE orfunnels;. Tanks with a cepacity o, I lO gEflons or l€ss.
whet SubstancGs fue covercd ?The notifcaiion requirsm€nts appry to usrscontainhg petror€um or certrin hazadous substances. iretoteum lriitiresgasoline' used oil, deser fuer, crude oir or any fraction trereor urtrm rriqrid
"t$""qrd condrions orremperatlre ano pres6ure (60 d€grees raruenneiiano ir.zp^ott_ttds pgl lg19r€ ildr absotutel. nazadous sOsAnois alo thce lound in
=HJ.91
04) ot fre-Compt€henrsve Envionmental Regonse, Conrpensatmano yaDilny $t of i9BO (CERCLA), with the exception d frose subsUncesregdal€d as hazanlos waste under SubtiUe C ot ifCnn.
Wher! To Nottly ?Send compteted brms to:
When To Nodry ? 1 . Orvners ol USTs in use or lhat have b€€n taken out of:X9"$1flg!):17!, urr sti-il in rhe ground. musl noliry ry r,,rav s, rgs6.z. e!,vnsrs who bnng USTS inlo l/p atter May 8. 1986, mu$ nod)r rlif,in SO dq/sot bringhg the UST into use. 3. [t fre State niquires n&fication of arryam€nctrn€nts b tadlity, send infomalion to State agsrry inmxrat€$
fll:ltbo : Iry ounef lvtto larowirgty hils to ndilV or gtrnits htse inbmatonry T.ry"cl p I dvit penatty rpt b sxc€€d Sl i,OOO for eactr tar* br unrkfino{iltcatim bnot Wen oiOruiriAr aSe i,rbmridi-b 9n en.
Owner Name (Corporation, lndividual, pru16 lgisncy, or Olh€r Entry)
s"*,Ad*J 7-Eleven, lnc.
Gasoline Acctg.
P. O. Box711
Dallas, TX 75221-0711
l, r€quircdDy Star6, givo the geographic tocarlon ol USTs by cbgrees, minutos, andseconds. Erarpre: tatirudo a2 .-So, tZ. H, Uongirgoe all ii, tt w
Facility Name or Company Site ldentifio( as appticabte
tr rt-a(krress is the sarne as in section r, check the box and proce€d ro s€clion il.l, a(tsioss is ditl€r6nt, 6nter addrGs betow:
Street Addr€ss/? ec,-t nV,-; S,it'
Numb6r (lnctude Area Code)253- -7?L-7/
Ep..!! F_orm TSgOt (Rov. 9{8 } Et€crronrc and pap"r r"**"
""""p,"bt".t.rovtous edttons may be usecl while supptres lasi.Pa96 l ol 5
T
tr
tr
tr cornmerciat
p eri*t"
Un[ed States
Environmental Protection Agency
Washing(on. DC 2(X60
Notification for Underground Storage Tanks
Railroad
F€deral - l.lon-lvlfl ihry
Federal - Military
lndustrial
Contractor
tr
I
Dr
D
r
n
tr
tr
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as true, accurate, and complete.
Name and ofncial t'te ol owner or owyl€/s
authonzed reprBs€ntative (Priril)
Randy Martin
Environmental Manager
9EPA
Federal Govemment
Sbte Go/srrn€nt
Local crorremm€nl
Gas Station
Petrcleum Distribulor
AirTaxi (Aidine)
Aircraft Orner
Aulo Dealership
n s"rr tnsurance
E. *rnr"*a tnsurance
E nirr Retentioo Group
D m""f Go/emment Financial Teg
EPA estimales public repo'tins burd.n for this torm ro ar"os" T:::11".:;ffiJ'**ffi"*til*TH"n l"rrctions, s.rha,ing and ,nahraining rhs dar,a nsedsd and cor,,ptsrins
notilication lorm rnay be used while supplies last. rvrrrr s' Prxr*
EPA Form TSl{}t (R.v.9€S) Eledronic and paperversions accedable.Prevous ettitrons may be us6d while supplies lasi.
Fom Apprcveo.
OMB No.20sO-Oo6B
USTs are locatod on hnd u,ihh an lndan
Res€natbn or on tusl lan(b oubile -]resenratioo boundades. I I
USTs areomed bya Mtive Arnerban
nalion orttbe. tr
Tribe or Nalion $,fi€re USTs are located:
Job Tite:
Environmental Manager
Address:
10220 SW Greenburg Rd.
Suite 470
Portland, OR 97223
Phone Nurnber (ndde Area Co<le):
a5* 7?c-7/ 70
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Randy Martin
Et n"r" met the fnancial responsibility requirements (in accordance wilh 40 cFR subpan $ by usng U1e lollowing mecfianisms:
Check All that Apply
f] c****
I surety eono
tr utterotcreoit
fJ eono Ragng Test
Pago 2 ol 5
9EPA
4. Mate?ial ol Constrrctlon (crl€ck all Ulat apply)
Asphall Coated or Bare Sted
Caftodin[y PEtec{ed Ste€l
Coated and CahodicatV polected Steel
Cornporite (St€el Chd wih Fibeq[ass)
Fiberglass Rein orc€d ptastic
Lined lnterior
Ercanalbn Lirer
Double Wall€d
PolEthylene Tark Jad(et
Concr€te
Unlqlown
l, Other, pteas€ spedry here
Check box itlank tus aner been Epair€d
5. Plping Materiat (check all thst appty) Bare Ste€t
Gah/anized St€€l
Fibeq[ass Reinforced plaslic
Copper
Cafrodcalty plotect€d
Douue Wall€d
Sryxhry Contairment
unloown
Otl€r, ptease sp€dry
6. PipingType "Sale'suctbn(nowtveattank)
(Check att that appM "U.S." Suction (vatve at tank)
pressure
Gravity Fesd
Ched< box il pi6*ng has aner been repair€d
Form Approved.
OMB No.205e0068
NotificAion for Underground Storage Tanks
Tank l.lo. I fanf Xo.
1. Status olTank (chectmvon€) Cunenty ln Use
Temporarily Cbsed
Pemanenty Closed
Z Deorhltdhum (nrontvyear)
3. Ertmffi Totll C.paclty (gallons)
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9EPA Unit€d Statos
Environmental Protection Agency
Washingtm, rc 20460
I Form,
I oMB r.ro.2
Notification for Tanks
\pprorr€d.
)5G0068
Tank ldentftcation Number TarrXft.. ,/Tanktlo. 2 Tankr.to. 3 Tank tlo.Tank ilo.
7. Substancc Currenty Storcd (or last Gasolln€
storud h lhc case ol cbscd tenks) Desel
(Ch€d(dltEtappfy) Gasohol
Korosen€
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8. Releaso[rct cdon (drcctall tntapply)
Manual tank gEuging
Tank fghtt€ss testing
lnvenilory Confd
Aubmalic tank gsughg
Vapor monitodng
Grounduater rnoniloring
lnterslilial monito.ing
Aubmalic line leak (bEcnors
Un€ tightl€sstssffig
l,lo rcbase rtetectbn reqrir€d (sucfr as scme types O,
$clion pipitrg, emerg8ncy gEllgrabr E I(s or fr€ld
corshrcted tanks)
Otler mefrtod alowed by lmplqn€frtrtg agsncy
(suci as SIR)
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\9EPA Unit€d Stiates
Environmental Protection Agency
Washingrton, trc 20460
Notification for Underground Storage Tanks
1. CIosUra or Chango ln Scnricc
Estimated date the UST w8s last us€d torsbdng rB$/ht€d
$bstances (monWrtay/year)
Check box if ltris is a change in s€ruice
2. Tank Closure
Eslirnated date tank dosed (rnnwrhy{ear)
(check all that apply betow)
Tank was nmored tom gourd
Tank was dos€d in gnurnd
Tank filled with inert mate.ial
Dsscdbe the inert fill matedal h€rB
3. SlUAssoosmcnt
Check box if lhe site ass€ssrnent was comfleted
Ched< box if avilence of a leak was det€cled
lnstallcr Ol Tank And Plping Mult ChGck All That
lnstaller certitied by tank ard piping manulacturers
lnstaller certiried or licensed by th6 impl€menting agency
lnstalhtion inspected by a registorEd engineer
lnstallation inspeci€d and apprwed by implementing agency
Manulaclure/s instalbtion checklists have been completod
Anothor melhod allorved bv State aoencv
lf so, pteaie speci,f hor6
Signature of UST lnstailler Certirying proper lnslafiation ol UST System
EPA Form 75il!,1 (Rcv. $9E) Electronic anct paper versions acceptaue.
Prevbus €dlions may b€ us€d while $rpplies hst
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Page 5 ol 5
UtarruST Program
Release Detection Checklist
lndicate below the corrosion protection methods in place for all UST system components.ldentify each dispenser by pump numbe(s).
lV
ofTanks E oennuee
Address l1 E Wqt*
for eact tank addltlonal
Number of tanks at the
lndicate if tank is siphoned or compartmented. Show related tanks.
Tank is in use.
lf not in use. oive date last used and deoth of oroduct in tank.
Material of construction of tanks
ll containment bucket is intact. clean. and free of oroduct. water. debris.
Tvoe of Overfill Prevention device
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearlv identified.
Containment sumps are sealed, free from water, product. etc.
ion tests are available (within six months of installation and every three years thereafter
Cathodic Protection Testino. Date of last test:
lmpressed Current System is checked for proper op'eratioh at least every
60 davs and the results of Dates of last three checks:
Show readings
Site Drawing North
\n
EEE
\\
Comments
White- DERR, Yellow- lnspfftor, Pink- Facitity/Owner
Uta,. UST Program
Automatic Tank Gauqinq lnterstitial Mon
PIPING LEAK DETECTION
n Piping qualifies as Safe Suction. Documentation is available and verifiable to show that piping operates at less than atmospheric pressure, has
only one check valve (under pump), and has proper slope of piping. lf all these criteria are met, no leak detection is required on the piping.
Piping method(s) used. Pressurized piping must have an Automatic Line Leak Detector and one other form
( Automatic Line Leak Detector.
one other form of leak deiection.
Tank 1 fank2 Tank 3 Tank 4*@o u@o ,6o MEO
t)rL U2 UB
P -a
@.z t 5[-h .z r rtr$zr sL3.2.1
Itl
Results:
Cert. Number ur t 5/Test Method: VZ
E Monthly monitoring. lndicate the fl .2 GPH Monthly Testing n lnterstitial Monitoring
method used:f] SIR E GW Monitoring
Show for the last 12 for each month.
COMMENTS
Type (Mechanical, Electronic, Other):
Manufacturer and model ofeach leak detector:
Date of tast teak detector performance "rr, 5l l{tGResutts:
lndicate type of test: Simulated Leak, 3 gph, .2 gph, .1 gph (3, .2, .1- electronic LLD only)
Tester name: fu*Wffue cert. Number UT TestMethod: TZ"llfYJtG?
Type of lM Documentation:
E Vapor Monitoring
method used: t I ATG Shutdown T
Circle Yes or No and identify by tank any exceptions to the answers oiven in the
on site document that the system is properly installed, calibrated,
operated, and maintained (system and tank setup reports, maintenance
records). Written documentation of calibration, maintenance, and repair is
for at least one vear after work is co
ATG console or other equipment used to take readings and perform tests is
accessible. and operati
Documentation of valid testing or monitoring is available for the last 12
months. Show results in table below.
The probe is located at the
lliXT"""lTi,l;'3,X0''lloou '"8'I P #2 #3 #4
The tank was filled to at least the minimum level required to ensure a valid
leak test. and the tank size is within the allowed and lower size limits.Third Party Minimum Level: 5
System is capable of detecting a release of regulated substances from any
of the orimarv tank/oioino within one month of release
Show results of monitoring for each tank for the last 12 lndicate Pass, Fail, lnvalid, or No Results for each month. For ATG tests, show ttre
level tested for each monlh,
M Un" tightness testing. Datg of last linq tightngss tesl
! Same as above Tester name: >.Ulrcl+dThd
Distribution: White- DERR, Yellow-lnspetor, Pink- Facility/Owner Ldatgim1205.doc
ttnWv,uo, *'l#[]PJiR.",{,FffLli+9f,I[Bi,I,=,?IX!9u,u,
TELEPHONE (s12) 451-6334 FAX (512) 459-'1459puRposE: coMpLtANcE_._ _ .__ , . T,E$-T RESULT SUMMARY REPORT
TEST DATE: 03/15/06 :
:
CLIENT: 7-ELEVEN, lNC.
P.O. BOX 711
DALLAS, TX75221
i\'WORK ORDER NUMBER: 2241282
CUSTOMER PO:
SITE:7-ELEVEN #25030
MARKET #1852
17 EAST MAIN ST
DELTA, UT 84624
MANAGER
i {aot)aec<otz12141841-6714
1 TESTTYPE: TLD-1
Line Leak Detector T
PRODUCT 'l
MIDGR,ADE
REG I'NLE,AD
PREMII'M
LINE
... ITIATERIAL
FIBERGLASS
FIBERGLASS
FIBERGI,ASS
DELMERY
TYPE
PRESSURE
PRESSURE
PRESSURE
TEST RESULT
Ar,,E, -'','C D
P
P
P
FIIiIAL LEAK RATE (sph}ABCD
0.000
0.000
0.000
Leak Detector Test
i/IANUFAC.TURER
\rEEDERROOT
VEEDERROOT
\/EEDERROOT
ITiANUFACTURERuoDE!#l,
EI,EETRONI
ELECTRONI
BLBCTRONI
IIODEL #SERIAL #
L7 47 95
L7 47 97
L66720
MODEL #SERIAL #I'AI{UFACTURER MANUFACTURER
owner oetaleo repon tnlormatron, vrstt www.tanknology.com , or contact your local
Tester Name: DAVID MATHIE Technician Certification Number: UT OlSl
Printed 03/1 6/2006'l 8:56 KOHLMEYER
WORK ORDER NUMBER22412 82
SITE: 7-ELEVEN #25030
SITE DIAGRAM
tttmgv
8501 N MOPAC EXPRESSWAY, SUITE 4OO
AUSTIN, TEXAS 78759
(512) 451€334
FAx [phone]
TESTDATE: 03/L5/05
CLIENT:7-ELE\IEN, INC.
7-11 # 25030
DELTA, UTAH
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Printed 03/16/2006 1 8:56 KOHLMEYER
FOR: 7-ELEVEN, lNC.
20819 72ND AVE. SOUTH
SUITE 206
KENT WA 98032
Contact: RANDY MARTIN
SITE: 7-ELEVEN #25030
MARKET #1852
17 EAST MAIN ST
DELTA UT 84624
BY:TANKNOLOGY
-,.#4WTbnW
CATHODIC PROTECTION
COMPLIANCE SURVEY
UST SYSTEM
-W-OJ*rl
Stephen Olenich Date: 04120104
(NACE Senior Corrosion Technologist #3222)
Work order: 2230266
8900 Shoat Creek Blvd., Building 200 - Austin, Texas 78757 - P.O. Box 9429 - Austin, Texas 78766-9429 - (5121451-6334 - FAX [phone]
04120104
Work order: 2230266
. COMPLIANCE SURVEY
GOMPLIANCE SURVEY
SAGRIFICIAL CP SYSTEM
7-ELEVEN, INC.
T.ELEVEN #25030
MARKET #1852,17 EAST MAIN ST
DELTA, UI 84624
I. SCOPE:
A cathodic protection survey was conducted on 04/19/04, on the cathodic protection system
for 7-ELEVEN, lNC. at 7-ELEVEN #25030, MARKET #1852,17 EAST MAIN ST, DELTA, UT.
The purpose of this survey was to meet regulatory requirements for periodic testing, and, more
importantly, to determine if the cathodic protection system at this facility meets NACE criteria
for cathodic protection. This NACE criteria indicates if the system is functionally controlling
corrosion.
The cathodic protection system for the underground tanks consists of factory installed
magnesium anodes such as the STI-P3 type. The UST facility consists of three 10,000 gallon
STI-P3 tanks and associated fiberglass piping'
II. RESULTS & ANALYSIS:
The structure-to-soil potential measurements are tabulated on the survey data sheets,
attached. The potential measurements for the underground tanks, with the cathodic protection
system energized, ranged from -977 millivolts lo -1264 millivolts.
III. CONCLUSIONS:
The results of the survey indicate that the structure-to-soil potential measurements for the
tanks did meet the -850 millivolts criterion for cathodic protection as established by NACE'
IV. RECOMMENDATIONS:
It is recommended that a structure-to-soil potential survey be conducted every three years
by a qualified corrosion engineer. The cathodic protection system should operate with minimal
maintenance and it is not recommended that any spare parts be kept on hand.
V. DISCUSSION:
Test Procedures: Description of test procedures utilized for this project are contained in the
Appendix.
STI-p3 Cathodic Protection System: The STI-P3 cathodic protection system is designed to
. COMPLIANCE SURVEY 04120104
Work order: 2230266
protect the outside of the tanks only. The risers/piping are electrically isolated from the tank
and are not included. The STI-P3 tank incorporates a good exterior coating and factory
installed magnesium anodes. The magnesium anodes are provided to protect the surface
areas on the tank where coating holidays exist and exposure to corrosion occurs. The surface
areas are very small and do not require a large number of anodes for protection. When foreign
structures are electrically shorted to the tanks (i.e. piping) the protective effect is depleted and
the magnesium anodes for the tanks are consumed rapidly. This is why it is very important to
maintain effective electrical isolation of the STI-P3 tank. At the time of this survey, no electrical
shorts to the tank(s) tested were found.
VI. REGULATORY REQUIREMENTS:
Federal and State regulations require cathodic protection systems to be checked
periodically. (Reference: 40 CFR, Part 280.31, "Operation and Maintenance of Corrosion
Protection".)
- All cathodic protection systems must be surveyed (tested)every three (3)years.
- The cathodic protection system must be inspected and tested within six (6)months after any
repairs to the UST system. (Reference: 40 CFR, Part 280.33, "Repairs Allowed".)
- All impressed current systems must be inspected every 60 days to see that they are
functioning properly. lnspections must be logged (documented)'
- Within six (6) months after initial turn-on of an impressed current system, it is required that a
General survey be conducted and any necessary adjustments made.
' APPENDIX: TEST PROCEDUR.04t20t04
Work order: 2230266
APPENDIX: TEST PROGEDURES
ln order to determine the effectiveness of the cathodic protection system, structure{o-soil
potential measurements were performed at representative locations throughout the subject
area. These measurements were collected after the cathodic protection system was energized.
These measurements are then evaluated to determine if an adequate level of cathodic
protection has been achieved.
The two (2) most common criteria for cathodic protection as established by the NACE
standard RP-02-85 "Recommended Practice - Control of External Corrosion on Metallic Buried,
Partially Buried, or Submerged Liquid Storage Systems" are as follows:
1. A negative (cathodic) voltage of at least 0.85 volts as measured between the structure
surface and a saturated copper/copper sulfate reference electrode containing the electrolyte.
2. A minimum negative (cathodic) polarization voltage shift of 100 millivolts measured
between the structure surface and a stable reference electrode contacting the electrolyte. This
polarization voltage shift is to be determined by interrupting the protective current and
measuring the polarization decay. When the current is initially interrupted, an immediate
voltage shift will occur. The voltage reading after the immediate shift shall be used as the base
reading from which to measure polarization decay.
These potential measurements were obtained, utilizing a copper/copper sulfate reference
electrode and a Fluke, Model 87 Digital Multimeter.
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September 1,2006
State of Utatr - DEQ
Environmental Health
655 East 1300 North
Logan, UT 84341
RE: 7-Eleven Inspections
Dear Sir:
In conjunction with your request for records for your upcoming inspections of our stores,
enclosed are copies of the most current Line lLeak Detector Test, Cathodic Protection
certifications and last 12 months of ATG reports for the following stores.
24299, 267 49, 24633, 23851, 25030
Should you have any questions or need additional information please feel free to call me
at: 303-740-9333 x319.
Sincerely,
@zaaU/
Antony F. Mikulski
Gasoline & Environmental Compliance Manager
AFMjat
Encl.
7-Eleven, Inc.
Cityplace Center East / 2711 North Haskell Avenue / Ddlas, TX^75204-2906 . Mailing Address: Box 777 / Dallas,TX7522l-0711
214-828-7011
Locarion N3ms 7-ELEVEN 1852-25030
Address 17 E MAIN ST
DELTA Srate UT 71084624
Number of tanks at the
lndicate iI tank is siphoned or compartmented. Show related tanks.
The results ol the last two cathodic
Dates ol last three checks:System is checked lor proper operation at least
60 davs and lhe results of the last three
HEIba6e
lndicate below the corrosion protection methods in place tor all UST system components. ldentify each dispenser by pump numbe(s)' Show readings
for the mosl
at!w'a
Comments
TANK LEAK
Veeder Root TLS-350 CSLD No Manifold
Circle Yes or No lor
on site document that the system is properly installed, calibrated,
operated, and maintained (system and tank setup reports, maintenance
records). Written documentation of calibration, maintenance, and repair is
lor al least one vear after work is
console or other equipmenl used to take readings and perform tests is
Documentation ol valid testing or monitoring is
lf not in center, show tilt Tilt: #1 C) #2 C\lactors from lhe setuD reoort.
probe is located at the yes
tank was lilled to at least the minimum level required to ensure a
leak test. and the tank size is within the allowed upper and lower size limits.
is capable of detecting a release ol regulated
PIPING LEAK OETECTION ALD LTTtr piping qualilies as Sale Suction. Documentation is available and veriliable to show that piping operates at less than atmospheric pressure, has
only one check valve (under pump), and has proper slope ol piping. ll all these criteria are met, no leak detection is required on the piping.
Piping method(s) used. Pressurized piping must have an Automatlc LIne Leak Detector and one
Automatic Line Leak Detector.
lndicate type oJ test:
Line tightness testing.
E Same as above Tester name:
tr Monthly moniloring. lndicate the
method used:
Show results ol
rype (Mechanicr(6ul) o*.n,
ManuJacturer and model of each leak detector:
Date ol last leak detector performance t""tr'7 1! 5^!] Results:
,** ::": ".*
r ffi:'[' fr4)! fl,:]ff::""-'# : 11 Test Method:
Results:
D
tr
lnterstitial Monitoring. Type ol lM Documentation:
GW Monitoring tr Vapor Monitoring
or No Results lor each month.
I
l
Eert. Numuer UT A tq / Test Method:
----T---
tr .2 GPH Monthly Testing
tr SIR
for the last 12 months. lndlcate
White- DEHH, Yellow"lnspstor, Plnk-
Owner Name 7-ELEVEN INC Location N6ms 7-ELEVEN 1852-25030
Address GASOLINE ACCTG.Address 17 E MAIN ST
6;1y DALLAS Stareil 7i6 75221 g;h, DELTA State UT 7ie84624
Contact BANDy MABIN phens [phone] Contact BoB DENTNNo Phone
Tank Number:1 2 3
Tank lnstallation Date 4116/1984 4116t1984 411611984
Capacity of Tank (in oallons)10000 10000 10000
lndicate if tank is siphoned or comDartmented. Show related tanks.
Substance Stored Gasoline Gasoline Gasoline
Tank is in use.Currentlv in Use Currenily in Use Currenllv in Us(
lf not in use, qive date last used and depth ol Droduct in tank.
Current vear tank taqs are in place.
Material of construction of tanks uatvanrc
Cathodic
uatvanrc
Cerh^di^
Galvantc
Caihodic
Material of construction of oioino Fiberglass Fibsrglass Fiberglass
Pipino tvpe Pressurized Pressurized Pressurized
Type of Spill Prevenlion device. Note on form il tank is filled by transfers
of less than 25 oallons. lf so, no spill prevention is required.Arrk
Spill containment bucket is clean, dry, and free of product, water, debris.Yes No Yes No Yes No Yes No
Type of Overfill Prevention device. Note on form if tank is filled by
transfers ol less than 25 oallons. lf so. no overfill orevention is reouired.e.rt *[l Fl-*T
lf an overfill alarm is the primary overfill device: Alarm is located where it
can be seen and heard. and alarm is clearlv marked.Yes No Yes No Yes No Yes No
Corrosion Protection method used on tanks ,(tl
Corrosion Protection method used on oioino
Corrosion Protection method used on flex connectors, swino ioints, etc.Arrenks. [ 5aetezt Ar disoense*: l/ aC f, Z,
Enclosed containment sumos at tanks and disoensers Ai ranks: Yes / No At disoensers: YgS No
Containment sumDs are sealed, free from water, product, etc.Yes No
lndicate dates of uoorades- linino. tank or oioino cathodic orotection
The results of the last two cathodic protection tests are available (within six
months of installation and everv three vears thereafter).Yes No
Tank Tester Date volts volts volts volts
Pioino Tester Date volts volts volts volls
Flex Connectors/ Swing Joints Ar rank
Tester Date Ar dismnsor
volts volis volls volls
volts volts volts volts
For lmpressed Current Systems: The results of the last three equipment
operation checks are available (reouired everv 60 davs).Yes No
tr Emergency generator tanks only; leak detection deferred.
tr USTs temporarily closed and empty; leak detection not required.
tr USTs temporarily closed, locked and secured.
coMMENrs c? , -r-0 I
I '";7*'n ^*n n ' j
l3 l]r
$$
Garv Harris- / insoected this racitttv on ? 9nn ? L
Sionature: ,/\
Owner/ooerator name:
sionature: Y (,r,-7-l I / "^-*r*/
Distribution: White DERR, Yellow- lnspector, Pink- Facilily/Omsr Ldch6ck0703.de
I/AC(? A
:n. Utah UST Program
TouK?nd Piping Leak Detectir,.r Facility lD 2000138
tvletrod wed f or tanls: ATG [4ethod used f orpipino: ALD LTT
lvlaruf acturer, nanB and nodel nunber of system
USTMAN SIR
Veeder Flnot Tr s-3so cSr D No Maniforrr Svstem3d patv cert. ava'lable Yes lrlo
Ail Fbcords on site docunent thd the systemis properv installed, calibrated, md
nainta'ned (systan and tank setup reports, mdntenatce recorG) .0v*
ATG IM Bvice docurBnbtion b available on-s ite (ow ner's nanml, etc.).[ve/ tto
Ail Quipnent used to acqlire dda, tale redings, perf ormtest is dequde, accessible
and f mctional. lrcl. ATG corsole, dipstick, etc.6E*
Ail Dcunentalion of valid testing or nonitoring is avail$le f or the hst '12 npnfrs. Show
testino or nmitorhq results in orid below.Yes Nlo
ATG The probe is locded atthe center d the hnk. lf not, tl're tilt correction factorf or erch
tank is shown on the tark setuc report.Cu^r'n
ATG The tark w as I illed to at least the nhinum levd reqdred by the nanufacturer's
equipnent [otocol to ensurea vald leaktest and thetanksize iswithn theallowed
tpper and lqrv er size lirits.\
Yes t{o
E60
IM Secordary barrier is properly placed ard corstructed, designed f or gw
consideratims, lns an acceptable pernBation rate, is conpatiUe w ifr the substance
store( is nm-conodiUe, and is nd in the 25-yr f loodplain (per site assessnent).
Yes M
C MTG
SIR
hventory readings f or prodrct inp-rts ard w ithdrawals are properly obtairBd ard
recorded. Fbadirgs are properly reconciled.Yes M
CSR Fbcords include he proper runber of water readirgs, ard w der readings are used to
adiust inventorv balances as necessarv.Yes t{o
C MTG
SIR
An appropriate tark calbratim chart is used and is araildle f or review.Yes M
CSlB Dspersers have current calbratiqr stickers or prorer cdibratbn daunBntation Yes Nlo
CSlR Dop tdces are prcsent and extend to w lhin one f od of tle tankbottom Yes No
Sho$, results of monitoring for each tank for the last 12 months. Indicate pass, tail, no results, or inconclusive.
Moffr 7to3 8/03 9/03 1 0/03 1 1/03 12t03 1to4 a04 3l04 4l04 5l04 6104
#[r
#L r
#)7
#
Tank and Line Tightrcss Testing, Line Led< IEtector Testirg:Tank 1 Tank 2 Tank 3 Tank 4
Date of last tightness test f or tanls:Test results
Mne andcertlicatim nunber d tester:Test ttrbthod
Date of lat tightness test f o piphg:Test results
Mne and certlicatim nunber d tester:r\<Test ltEthod
Autonatic Line LeakDetector tvrc and rmdd k t0\tr E tr
Date of last leak detector perf ornance test:Test results
Safe Suction pping: Docunentdion is availsle and vedf iabb to show tlnt piping operates at less thm atnospheric
pressure, has only me check vaMe (under punp), and has proper slope of rjplnq.
Yes Nb
Conrrents LI 6-1,\-CL
ofPa€
r*-l \ utarr usr Program
Release Detection Inspection Checklist
€,4,q_t7efr,
o 2oo136
Ownership of Tanks Locatlon of Tanks ,z *
owner Name '|'e'UVelt , tn/(Location r.rare 7 e.EvN 2to3o
Address itlZZB Sl^!. (,ref.th*ra" ?A Address l'7 EA\T t"tA,( SI
cl* QctzntNo State CR zio9l223 ciy f)erTq state ur 2i"f,,4624
contact &:r, NNntri! pnoneJ0S'9'l'l 17t3 Location contact i)tn NIL pnone 43!- 6(,4 4cq
Complete lor each tank. If the facility has morc than 4 tanks, complete the informatlon for addltlonal tanks on a separate form.
Number of tanks at facility: .3 Tank 1 Tank 2 Tank 3 Tank 4
Tank lnstallation Date 4' 16'84 4'rl.f,,t 4 -//,-P.a
Capacity ol tank (in gallons)iO t oK)/0,cq)in, N0
lndicate if tank is siphoned or compartmented. Show related tanks.
^{c
tlc NC
Substance stored mIDG,ADE Rect hAhtrxe lz,?cnu (A{*u
Tank is in use (Yes / No). lf not in use, give date last used I 'l -/
lf not in use, depth of product in tank (in inches)
Answortho followlng for all tanks. Note any exceptlonE ln the last column.
Cunent year tank tags are in place %s
Material of construction of tanks f.rtrfe++
Material of construction of piping FRT>
Piping type Pi<ds /.rr[ - t(wJ
Type of Spill Prevention Device. Note if tank is filled by transfers of less
than 25 qallons. lf so, no spill prevention is reouired.f 6x1g:flu Er IJEO
rype or uvenilt Hrevenlron uevtce. Note tI tanK ts ttiled by transters ot
less than 25 oallons. lf so. no overfill orevention is reouired.Awo tttuT#'i. q oililuutdut lt
ll an overfill alarm is the primary overfill device: Alarm is located where
it can be seen and heard. and alarm is clearlv marked Yes (ttd
Corroslon Protectlon. Answer the following for all tanks. Note any exceptions in the lasl column.
Corrosion Protection method used on tanks Srrps
Conosion Protection method used on piping M FRf)
Corrosion Protection method used on flex connectors 'Bcdf
Enclosed containment sumps at tanks (subpump) and dispensers Yes ( l[o.t 6rztveu [*tr-;wrt.
lndicate dates of upgrades- lining, tank or piping cathodic protection.
Cathodlc Protoctlon Testing. Show the reaults ol the most rccent lest tor each tank, llne, or flex connector.
lhe results of the last two cathodic protectaon tests are available (within
6 months of installation and everv 3 vears thereafter)-Yes No
rank rester G(lltrRT S(r{u-TZ A Alffi, ,^* 5 /Slt t _ /A4Z vorts - Df e vors - /eo4 vors voll
Pioinq Tester tlA Dare volts volts volts volt
Flex Connectors U [* subpump
Tgster Datg Disnenser
volts volis volts volt
volts volts volls volt!
For impressed current system: The results of the last three equipmenl
operation checks are available. (required everv 60 days.)Yes No
rcc,mments NOCthUteS fitcZ (nlf WttZtTo,t. lO*t> DtmEfifiort! nlDtAttntvr.
I
Pase / ot 2
t(nameti/AQN-D'l !r&W certiwna |rrspectedtheabove-namedfacitityon Oatet 4W 3'?C'C-3
rnsoector,s sionarure /tr/fuf *lte 3 h_C3
owner/operator name: Y //"r-T tA,r,t.n5 signature: X ,-rr"*
Distribution: White-DERR.rev0902wpd
Utah UST Program
Tank and Piping Leak Deteclion
?-rl
ro ?oo I38
Method used for tanks: 5 r(i Method(s) used for pipiasi [-{oM€r? E?.',
Manufacturer. name and model number of svstem: t i 5Ti"t\ ( rJ S-' Z iS System 3'o party cer1. availableCe\ No
Clrcle Yes or No for each question. ln the last column, explain and identify bJ ta11tlny exceptions to the
ATG IM Records on site document that the system is properly installed, calibrated, and
maintained (svstem and tank setup reDorts, maintenance records).Yes No
ATG IM Device documentation is available on-site (owner's manual, etc.).Yes NoIEquipment used to acquire data, take readings, perform test is adequate, accessible and
functional. lnclude ATG console, dipstick, etc.GNosDocumentation of valid testing or moniloring is available for the last 12 months. Show
i6clin^ ^r mnnitnrinn racr rlic in nrid halnrar @*"
ATG The probe is located at the center of the tank, or, if not in the center, show the tilt faclor
for each tank from the tank setup report"
Center Tilt Factors: #1 #2 #3 #4
ATG The tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test, and the tank size is within the allowed
uooer and lower size limits.
Yes No
IM Secondary barrier is properly placed and constructed, designed for groundwater
considerations, has an acceptable permeation rate, is compatible with the substance
stored, is non-corrodible, and is not in the 25-yr flood plain (per site assessment).
Yes No
ifis(lnventory readings for product inputs and withdrawals are properly obtained and
recorded. Readinos are orooerlv reconciled.f"rl) *"
ICEFI Records include the proper number of water readings, and water readings are used to
adiust inventorv balances as necessarv.v". @ { nTC( t(LY)at N G) nro f Ful4t t- .
rc@{
MTG
An appropriate tank calibration chart is used and is available for review.(d *"
rc(sEl Dispensers have current calibration stickers or proper calibration documentation.( yes) tto
rcfSHl Droo tubes are oresent and extend to within one foot of the tank bottom.6B r.ro
Show results of monitorino for each tank for the last 12 months. lndicate Pass. Fail. No Results. lnvalid (ATG) or lnconclusive {SlR).
Mol/r L-0i i- 03 t2 'cz rt- 07-tL) c'2 d1'07 0b o?(.)l 'crf d6 c2 i)J- ''J2 O.? .Lt2 (l'J cr ?
#L t,P P i)t)l/12 l,t))I t>p
#a l)l'i)i)/)l)i)j)/)l)t-P
#3 p t)i)l)i)l)I)l)t'P P p
#
Tank and Line Tightness Tesling, Line Leak Deteclor Testlng:Tank 1 Tank 2 Tank 3 Tank 4
Date of last tiohtness test for tanks: ( Zq'Cl'L Test results /n':tz !l P4rr
Name and certification number of tester: JotiN LtQuyA ur O i 4 t5 rest Method: NFtu\ 3?\' ?,'l 4
^tO.A
4cCFt? ltr,
Date of last tiohtness test for oioino: G ' 7'\ - t:'Z Test results Fl,rNt('ailt 6.firtrcr,v{kL {t^nU,,r;ne
Name and certification number of tester: '.lo,W U4GQwwt ur o t{f. rest Method: ltgl- 4o CFP ?tf.44 (.4)
Automatic Line Leak Detectors. lndicate type and t
model number for each leak detector. (ffi#elfu H*$fusl];:H4finffiiI ME S
I
Date of last leak detector oerformance test: G '?4 C2-Test results (',qis Pnss l.r,s\
Safe Suction piping: Documentation is available and verifiable to show that piping operates at less than atmospheric pressure,
has onlv one check valve (under oumo). and has orooer slooe of oioino.
Yes No
Comments
.- /'-7
Pana (- al .z^
Distribution: White-DERR, Yellow-lnspector, Pink-Facilily/Owner Ldall.wpd rev0302
Release Detection lnspection Checklist
(- zo-obV
Location of Tanks ,/.
l"z.lr.-,r1 Phone
Complete for each tank. ll facility has more than 4 tanks, complete information lor additional tanks on separate form.
Number of tanks at facility:
Capacity of tank (in gallons)
Tank is in use (Y) or, if not in use, give date last used
lf not in use, depth of product in tank (in inches)
Answer the following for all tanks. Note any exceptions ln the last colunm.
Current year tank tags are in place
Material of construction of tanks (steel, FRP, composite, etc.)
Material of construction of piping (steel, FRP, flex plastic, etc.)
Piping type (pressure, safe/US suction, gravity, etc.)
ype oI Sptil Prevention Device (<5 gal, >5 gal, cont. sump, etc.
filled bv transfers of less than 25
if filled by transfers of less than 25 oallons. lf so. no overfill
or overtill alarm: Alarm is located where it can be seen and heard. and
Corrosion Protection. Answer the lollowing for all tanks. Note any exceptione in the last column.
Method used on tanks (NM, CS, lL, lC, SA, NP)
Method used on piping (NM, CS, lC, SA, NP)
Method used on flex connectors (8, CS, NC, CP, NM, NP, N/A)
Enclosed containment sumps at tanks (subpump) and dispensers
lndicate dates of upgrades- lining, tank or piping calhodic protection.
Cathodic Protection Testing Complete for each tank.
6 months of installation and everv 3 vears thereafter).
Tank Tester Date
FIex Connectors sub pump
Tester Date
For impressed current system: The results of tne laslthreeEqlrpnrent
(-// /t
( -21-
4-^444/L<_ Date
Method used for tanks:
Manufacturer, name and model number of
tank anv: exreptions,to tha, snswsr in Ere'fi rstYes.or No lor each question' ln {!+ Iigt, col,umn, explain and
Records on site document that the system is properly installed, calibrated, and
and tank setup reports, maintenance records).
Device documentation is available on-site (owner's manual, etc.
Equipment used to acquire data, take readings, perform test is adequate, accessible and
functional. lncl. ATG console, dipstick, etc.
Documentation ol valid testing or monitoring is available for the last 12 months. Show
The probe is located at the center of the tank. lf not, the tilt correction factor for each
The tank was filled to at least the minimum level required by the manufacturer's
protocol to ensure a valid leak test and the tank size is within the allowed
Secondary barrier is properly placed and constructed, designed for gw considerations,
an acceptable permeation rate, is compatible with the substance stored, is non-
and is not in
lnventory readings for product inputs and withdrawals are properly obtained and
recorded. Readinqs are properlv reconciled.
Records include the proper number of water readings, and water readings are used to
An appropriate tank calibration chart is used and is available lor review.
have current calibration stickers or proper calibration
and extend to within one foot of the tank bottom.
Show results of monitorinq for each tank for the last 12 months. lndicate pass, fail, no results, or inconclusive.
Tank and Line Tightness , €$ing, Lihe Leak [leteqtor Tesung:
Date of last tiqhtness test for tanks:
Name and certification number of tester:
Date of last tiohtness test for oioino:4 - I + -
Name and certification number of tester:l ltlr ^ lt_ .
Date of last leak detector performance test 4 - [ Ll -
Safe Suction piping: Documentation is available and verifiable to show that piping operates at less than atmospheric pressure,
has onlv one check valve (under oumo). has orooer slooe ol oioi
/*or',.\ c.tl S{rr
Si
Utah;tI$:t.Progrem
Tank. Cnd.'P.ipitt,,Lea,h' DGt$ctiofi
Ldall rev0201 .wpd
-4*
November 28,2001
Mr. Dave Wilson
State of Utah DEQ/DERR
168 North 1950 West
Salt Lake City, UT 84114
RE: 7-Eleven #25030, 17 East Main St., Delta, UT
Dear Mr. Wilson:
For your inspection at the above referenced site, enclosed please find the
following documents:
Line and Leak Detection Test dated 4128101
Statistical lnventory Reconciliation Report Oct. 2000 - Oct. 2001
3 Year Cathodic Protection Certification dated 513101
Should you have any question or need additional information please do not
hesitate to call me at [phone].
Sincerely,
HHOTIVE[)
Nov 2 I 2001
DEO
iriirronmenlll Resporrse & h'emediation
BD:rr
Environmental Services Department I 10220 S. \W. Greenburg Road / Suire 470 / Portland, Oregott 97223
Phone [phone] / Fax [phone]
Work Order: 22L6252
5F1-" :
John l-uhrum
l)ccititn l'r:sillg Sp<.i u I it
I i I Jv )iun,4 t,ul<.h Rntul
Srrkri. { , \JorJ
3t)l-.t9t:htih
Na, I '/, r,+).ilrr
Crrtifitatiou
[):rtr:: 04'-t0r'01
l-aciliry. ID: 100rir .'18
7.i:levea rJ-r0i0
t7 Eart Main Srrcet
Orlta, I.'T EJ61.t
! csr Date: 04i28.j01
Iest Numhet: 04ltatll I
Operat<rr: JtrlurLabr.rrrn
tltulr ('erlilicate Ncr.: I. f0i.l8
Ilrr:rsu rize<t Prod uct l.inrs
The abore location has irceu te$ted using lhe Hurner'Y Pipeline Tester. This pipelirrc leak dctection
sy,stem nrers all requirernents ret tirrth bl,NIPA 3?9-87 and I- SF.PA 40 CFR Part 260 nnd has
reL('ivcd third part 1' crililir:ati.)n.
PL'ase see the encloxd Third Parrl.Cenificrtion ftrr drrrrils.
lJnleaded Rcg
Urridqde(l 1.ti4
Red Jscket
Re<l lccltrrt
Red Jackct
5(l psi
50 psi
50 psi
,000
000
.000I iJnlea.JeJ Prcrn.Pass
Line t,esli Detectors
Tht mecharical line luak rlclectrlrs at rhc atxlte location \r,.cre te$&d in sccordancc wifh IJSF.PA rfO
('[R 2E0.41(a).
Unlcaded Reg.
L nleaded Mid.
Vlrporless !\I.D'rll,00 Furrctional
FituctionalVaporh'ss Mfg
I Unleaded Prcm. Va;nrks"- )vJfg. LD 20tX) Fun+tional ]tl:t
Ceni6ed Tegtcr'
Tanknology-NDE 8900 Shoal Creek, Building 200 Austin, Texas 7g757
, N0u-28-2A4L fi,.42 ?L4 84L 6?4? P.A2/L4
Octoberr 2000
Vecder-I{oot Scrvicts Comprny dhdtJslMA}'l
12265W, Duyaud Avc. 'Suirc 300't*gwood, CO 80228
l-u)0.2s3{0s4 . (!03) 985-801I r FN( [phone]
271I Nonh Hsskcll Avc.
Dgllas, TX 7520/.
17 EASTMAIN ST
DELTA, UT t46!4
SIR Provlder:USTMAN Phone: G03) 986-E0l I
SIR Version:95.28 Report Date: LllrcA000
Tank Tank end Line Status Calculaisd
Leak Rate
ph
Product Gegactty
Grllor
SEles
Grllons
Dellvsrlcs
Grlloru
I Pass -0.01 MI,JL 10000 772t 9005
2 Pass 0.02 RUL 10000 352 I0 410E6
3 Psss -0.05 PUL 10000 3528 3002
I)ocumcnt priat<l on: Novcmbcr 2tlr 200l Prgc:J
N0u-28-2441 LLt42 THE SOUTHLRND CORP.'{ November,2000 ^'
2L4 84t 6?47 P.g3/!4
(214) t28-7E05
271 I Nonh Haslrell Ave,
Dallu, TX ?520a
r852.25030
17 EAST MAIN ST
DELTA UT t/1624
SIR Provider:USTMAN Phone: [phone] I
SIR Version:95,28 Report Date: l?l5l2O00
Tanlc Trnk and Line Statur Calculaled
Le.k Rate
9h
Product CEpBcity
Gdloru
Saloa
Grllor
Dellvrrics
Grlknr
I Pass -0.01 MUL 10000 533S 4252
2 Pos 4.04 RI.JL 10000 28175 25007
l Prss -0.01 PUL r 0000 2512 1750
vcodcr-Root Scliccs Comprny dbI/USTMAI.I
I 2265 W. Blyrud Avc. ' Suitc 300 . Lskolood, CO 80228
l -80G253-t054 . (303) 986.80 I I . F^)( O03) 986-t22?
Documcnt printed on: Novcmbcr 2& l00l Pegc:l
Company:7.Elcvcn, Inc.Phone: (214) t2t-7E05
Address:271I Nordr Haskell Avc.
Dsllcs, TX 7520a
N0u-28-2441 LLz42 THE SOUTHLRND CoRP. 2t4 84L 6?4? P.A4/L4
Itllrll]*\ rrrlafl{r]l}aa. ^.llbaferJ s6vr]rrrtr.vr \v-\, -sYrvr r
December, 2000
vccdcr-Root Scrviccs Conprny dha/USl'MAN
12265 w. BaSnud Avc.'Suirc 300'Irlccrood, CO 8022E
l -E00-253-E054 . (303) 986-E0l I . FAX (303)
'E6-t227
l? EASTtvIAIN ST
DELTA,UT t4624
SIR Provlder:USTMAN Phone: [phone]
SIR Version:95.28 Report Dato: 0l/16/2001
Tank Tank and Une Status Cdculatcd
Lrck REtc
ph
Product Capacity
Grlhm
Sales
Gellons
Delivcricr
Gdlom
I Pass 0.01 MUL 10000 4565 3750
2 Pass 0.0r RI,'L r 0000 25262 24505
3 Poss 0.0t PUL lomo 242t 2354
Documcat prirtcd oa: Nuvrobcr 28.2O01 Pr6cl
NOV-a9-aAA| 17.42 THE1.r.Y-.7{\., _.SOUTHLRND CCIRP.
Vcsdcr.Ront Scrvices Conrpmy dbi/USTMAN
ln6sW. Bapud lw. r Suirc 300 . Bkcu/ood, CO 80228
l -t0G253-8054 . (303) 9t6-80 r I . FAX [phone]
214 e4t 6?4? P.O5/t4
Phone: [phone]E05
271I Norfi Haskcll Avc.
Dsllas, TX 75204
17 EASTMAIN ST
DELTA, UT 8462/
SIR Provider:USTMAN Phone: (303) 9t6-t0ll
SIR Version:95.28 Report Date: 03/0512001
Tenlt Tcnk snd Line Statue Calculated
Loak Rato
arh
Product CEpacity
Grllols
Sales
GJlour
Dellverles
Gollots
Psss 0.0r MUL 10000 4343 5179
2 Pess -0.0t RUL 10000 u484 24980
3 Pass 0.01 PUL r 0000 20rl 2504
f)ocurncnt priotrd on: Novcmbcr 2t, 2001 PegcC
NOU-28-24a1. 1,T142 THE SOUTHLAND____xJ CORP.
Febmary,200l
VccdcFRoot Seviccs Comprny dbrArSTlvIAN
12265 W. Drylud Ave, 'Suitc 300'Llkcwood, CO 80228
l-80c253-8054 . (301) 18&801r . FA)( (J03) 98(4227
2L4 941, 6?4? P.66/L4\r-
271I North Hasksll Ave.
Dallas, TX 75204
17 EASTT#.INST
DELTA,UT 84624
SIR Provider:USTMAN Phoner (303) 986-801 I
SIR Verslon:95,2D RepoiDate: 0311612001
Tank Tank and Llne Staluc Calculated
Leak Ratc
ph
Product Capacity
Grlloru
Seles
Gall6,tl5
DeliYerics
6dlolu
I Pass 0.00 MUL r 0000 3798 2503
2 Prss 0.02 RUL r0000 20633 zzt0t
3 Pass 4.02 PIJL 10000 r 86S r500
Documort prlntcd on: Novcmbcr 2& 2ll0l Pegc:l
N0u-28-2441 U.t42 THE SOUTHLRND CORP. 21,4 Ut 6?4? p.A?/LA.!-Y-7IV YE..v.-e- -, -_:::-
March, 2001
Vcodrr-Roor Scrviccs Cornp$y dba/UST[lAN
I 2265 w. Bcysud Avc, ' Suirc 300 . Iakcwood. CO 80228
l-t0G253.8054 ' O03) 986-801I r l:'Ax C303) eu6.s22?
Company 7-Elcven, lnc.
271t North Haskell Ave.
Dallas, TX 75204
17 EASTMAIN ST
DELTA" UT 84624
SIR Provlder:USTMAN Phone: (303) 98G801 I
SIR Vereion:95.28 Roport Date: C/,ll7l200l
Tank Tank and Lina Siatus Calculated
Lek Rare
Fi
Producrt Copadty
Gill0rrs
Sales
Grlhu
Deliverlet
Grllotu
Pass 0.00 MUL r0000 5929 7555
2 Pass 0.00 RUL 10000 29251 2750/,
3 Pass -0.04 PUL 10000 2672 3006
Document prlrrrcd on: Novqnbcr 2& 1001 Prgcd
NOU-28-2AA1 11:43 Tl€ SoJTHI-AND CoRp.rtrt .rFtt t orr.rt !-. ar-_-.-:J 2t4 Ut 6?4? P.O8/L4
-s5v-!7\ev- \v--s, -r-rv. D
2001
Phone: [phone].E!cl/cll, Inc.
271I North Haskcll Ave.
Drllas, D( 75204
17 EASTMNN ST
DELTA, UT 846U
SIR Provlder:USTI,TAN Phona: (303) 986-801 I
SIR Version;95.28 Reporl Date; O5ll6f200l
Tank Tank and Line Slatus Calculated
LeaI Raie
9h
Product Gapaclry
Grllom
Sales
Gollons
Drlivcries
GJlaar
I Pasr -0,n Mt,L t0000 6693 5001
2 Pass 0.03 RUL I 0000 30840 28004
I Pass -0.05 PUL t0000 3r88 2554
vocdr-tbor Scrviccs Compury dbdUS'fMAN
12265 w. Belaud Aw.'Suirc 300'Isl'ceDod, CO 80228
r{0e253{054 . (303) 98&80t I . FA)( G03) 986-8227
Documcnt printcd ou: Novcnbrr ltr 200!Pagel
NOU-28-2641 LLz43 THE SOUTHLFND CORP.21,4 8,4l. 6?4? P.A9/L4a,r-rrr.tl, rrf..ilrlrle. l.r r lrr]!il J r\!!s,rr!}r.rtu!rrrr \r[r,\,rr asl,lrr ]
M1Y.2001
Phone: [phone]-Elcvcn, Inc.
271I Nonh llrskcll Avc.
Dallas, TX 75204
17 EASTIvIAIN ST
DELTA. UT 84tr,z
SIR Provider:Lrsll4AN Phonc: [phone]
SIR Vorslon:95,28 Repon Dae: r,16ll?200l
Tenk Tankend LineSt tu3 Calculated
Lcalr Rste
arh
Product Crpaclty
(irllrtrn
Saloe
(irlhm
Dollvcrlcs
(idhlla
I Pss6 -0.01 MI,'L 10000 6960 901 8
.,Pass 0.00 R.UL !0000 336t8 379t7
3 Pass -0.02 PUL 10000 3289 4267
vccdcr-Roor Scniccs Comfany dba/t SIMAN
12265 w. Bryaud Avc.'Suirc 300 r l:lrcwood. CO 80228
r-800-253-t054 . (301) 986.801 I * FA)( (303) et6-t227
Documcnt prlnrcd ou: Novcrubcr 18,2001 Prt.rt
NOU-28-2641 11:43 THE SOUTI{LNND CORP.
Voodcr-Rmr Scwioc.s Compury dbJIJSTMAN
12265 w. Btlaual Avc.'Suitc 300'hkryood, CO 80228
l-800-2s3{054 i (303) 986.S01I . FA)( (303) 98&.SZ27
2L4 UL 6?4? P.L6/L4
r,lll,llf,|l( lrf-].t jrtel ltl t !tr]r,a, rl!tU{lrat]..{3.v8 \e5r, -wrv. .
June,2001
7-Elevor, Inc.
27ll NorthHs*ellAvc.
Dallas, TX 75204
Phone: [phone]
I7 EASTMAIN ST
DELTA,UT E'624
SIR Providen USTMAN Phono: (303) 986-801 I
SIR Verslonl 95.28 Report Date: 07lltl200l
Tank Tanlt and Llnc Status Calculated
Lsak Rate
gPh
Prodsct Gapaclty
Gdlong
Sales
Grlloru
Delivcrles
Glllrrm
Fass -0.01 MUL t0000 7325 5005
,PEss {.03 RUL t0000 34347 3ts06
3 Pass .0.09 PUL I 0000 344t 2005
Documcnt printcd oo: Novrmber lt, l00l Pegc:l
NOU-28-2441 Ll.43 SOLJTHLAND CORP.
July,2001
Vecdcr.Roor Scliccs Con:prny dbe4lSTMAN
122(5 w. Brlnud Avc. ' Suitc 300 r l:lccwood. CO 80228
r {00.253.8054 . (303) 986.801 I r n^X G03) 98G8227
2t4 WL 6?4? P.LL/LAJHE
(214) t28-780s
271I North Haskcll Ave.
Dallss, fi 75204
t852 - 25030
17 EASTMAIN ST
DELTA, OT 84624
slR Provlder:USNdAN Phonc: (303) 986-801 I
SIR Version:95.28 Report DEte: 0E/15/2001
Tank Tenl md Llnr Strtus Galculated
Lrak Rate
grh
Product Gapecity
Gdlonr
Saloe
GElonc
Dellverlec
Gelhtu
Psss -0.0r MUI,I 0000 81 80 9506
2 Pass 0.00 RI,JL r0000 3349 I 2805E
3 Pssc -0.06 PUL 10u00 359s 550t
Docurncrrt priutod on: Novcnrbtr 2t, 2001 Prgc:l
NOU-28-24@L L1,243 THE SOIJTHLRND CORP.
tt-v-){ YEry"Y-' '- t Y-'Y
Augustr 2001
214 UL 6?4? P.L2/1.4---r---
Veado.Roor Scwices Comprny db./t STMAN
l2,il65 W. Brnud Arr. r Suite 300'Lrkwood. CO 80228
1.300-253-8054 . O03) r8680t I . EA)( (303) r8G8,,27
2?l I Nor$ Haskcll Avc.
Ddlrs, TX 75204
17 EASTMAIN ST
DELTA. UT 84624
SIR Provider;USTMAN Phone: (303) rEC8Ol I
3lR Verslon:95.28 Ropon Deb: 09lZV20Al
Tank Tank and Llne Stetus Cnlculated
Leak R.tc
ph
Product Capacity
(idloni
Sales
Gallors
Delhvotloo
Grlhnr
I Psss 0.01 MUt r0000 781 r rs06
2 Pass .0.02 RUL I 0000 3r672 36862
3 Pass 4.04 PUL 10000 3258 3503
Documcnt prlutod on: NovcmDcr 2& 2001 Prgcd
NOU-28-2AA1 11:43 THE SUUTI-U-AND CORP. 2L4 84L 6?4? P.L3/14rrlrrrllx( rrf.rlr!3rts s t !.tf!r. J ---::^-:H.Y" \Y--"
Sentember.2001,2001 SEE
Cornpany:7-Elwen, Ina.Phone: (214) t28-7t05
Mdrsss:271 I Nonh Haskcll Avc.
Dallas, TX 752M
t852 - 2s030
17 EAST MATN ST
DELTA,UT 84624
SIR Provider:UST},IAN Phone: [phone]
SIR Verslon:95.28 ReportDate: 10/18/2001
Tank Tank and Une Statuc Galculaied
Lcak Rate
8('tr
Produst Capacity
Crllang
Salec
Gillons
Deliveries
Otllur3
I Prss 0.00 MUL r0000 7939 9503
2 Plss -0.03 RUL I 0000 12746 32105
3 Pass -0.06 PUL r0000 3t66 225t
Pagc:l
Vccdcr-Root Scrvic.cs Corapany db/t STMAN
12265 W. l4rsud Avc. ' Suia 300 t Lckcwood. C! 80228
1.80&,253-8054 . (303) 986-80t I . FAX (303) (r{t6-8227
Documcnt ;lrin(cd on: Novcmbcr 2t, 2001
271I North Hiskpll Ave.
Dallas,'lX 752M
N0u-28-2641 LLt44 THE SOJTHLRND CORP.2L4 8(41, 6?4? P.1,4/L4tra
(2t4) 828.7805
Prgc:l
-- --dtou;,itiir'ii
7-Elcvan, tnc
vcadcr.Roor Soviccs Con.tp.ny dbyUSTMAN
I 2265 W. Bayrud Ave. ' Suite 300 | lakewood. CO 80228
1.800.253.8054 . (303) 986.801 I . I'AX (3ot) 986-8227
I7 EASTMAIN ST
DELTA,W 84624
StR Providor:USTMAN Phone: (303) 9E(r-801 I
SIR Version:95.28 Report Date: llllglzlt(ll
Tank Tank and Llnc Status Calculated
Leak Rate
ph
Product Capacity
Grllorts
Salea
Gdlone
Deliverics
Gsllons
I Pass .0,03 MUL 10000 5823 551I
)Puse -0.12 RUL r 0000 30693 3r813
3 Pass 0.00 PUL 10000 3403 3757
Documcn( printcd on: Novcmbcr 2t, 2001
TOTRL P.14
1
..::11:.
i, bTbn
CATHODIC PROTECTION
COMPLIANCE SURVEY
UST SYSTEM
FOR:7.ELEVEN, INC.
10220 S.W. GREENBURG ROAD
SUITE 470
PORTLAND OR 97223
Contact: BOB DENINNO
7-ELEVEN #25030
MARKET #1852
17 EAST MAIN ST
DELTA UT 84624
SITE:
BY: TANKNOLOGY
/A///A6
Gilbert W. Schutza Date: 05/03/01
Corrosion Engineer Manager
(NACE Cathodic Protection Specialist #410A)
Work order: 2216252
8900 Shoal Creek Blvd., Building Z)0 - Austin, Texas 78757 - P.O. Box 9429 - Austin, Texas 7876G9429 - (512)451€334 - FAX [phone]
coMPLtANCE SURVEY
^
05/03/01
COMPLIANCE SURVEY
SACRIFICIAL CP SYSTEM
7-ELEVEN, INC.
7-ELEVEN #25030
MARKET #1852,17 EAST MAIN ST
DELTA, UT 84624
I. SCOPE:
A cathodic protection survey was conducted on 0/,l3OlO1, on the cathodic protection system
fOr 7.ELEVEN, INC. at 7-ELEVEN #25030, MARKET #1852,17 EAST MAIN ST, DELTA, UT.
The purpose of this survey was to meet regulatory requirements for periodic testing, and, more
importantly, to determine if the cathodic protection system at this facility meets NACE criteria for
cathodic protection. This NACE criteria indicates if the system is functionally controlling
conosion.
The cathodic protection system for the underground tanks consists of factory installed
magnesium anodes such as the STI-P3 type. The UST facility consists of three 10,000 gallon
STI-P3 tanks and associated fiberglass piping.
II. RESULTS & ANALYSIS:
The structure-to-soil potential measurements are tabulated on Table l, attached. The
potential measurements for the underground tanks, with the cathodic protection system
energized, ranged from -1000 millivolts to -1064 millivolts.
III. CONCLUSIONS:
The results of the survey indicate that the structureto-soil potential measurements all meet
the -850 millivolts criterion for cathodic protection as established by NACE.
IV. RECOMMENDATIONS:
It is recommended that a structuretosoil potential survey be conducted annualty by a
qualified corrosion engineer. The cathodic protection system should operate with minimal
maintenance and it is not recommended that any spare parts be kept on hand.
V. DISCUSSION:
Test Procedures: Description of test procedures utilized for this project are contained in the
Appendix.
GOMPLIANCE SURVEY A 05/03/01
STI-P3 Cathodic Protection System: The STI-P3 cathodic protection system is designed to
protect the outside of the tanks only. The risers/piping are electrically isolated from the tank and
are not included. The ST!-P3 tank incorporates a good exterior coating and factory installed
magnesium anodes. The magnesium anodes are provided to protect the surface areas on the
tank where coating holidays exist and exposure to corrosion occurs. The surface areas are very
small and do not require a large number of anodes for protection. When foreign structures are
electrically shorted to the tanks (i.e. piping) the protective effect is depleted and the magnesium
anodes for the tanks are consumed rapidly. This is why it is very important to maintain effective
electrical isolation of the STI-P3 tank. At the time of this survey, no electrical shorts to the
tank(s) tested were found.
VI. REGULATORY REQUIREMENTS:
Federal and State regulations require cathodic protection systems to be checked periodically.
(Reference: 40 CFR, Part 280.31, "Operation and Maintenance of Conosion Protection".)
- All cathodic protection systems must" be surveyed (tested) every three (3) years.
- The cathodic protection system must be inspected and tested within six (6) months after any
repairs to the UST system. (Reference: 40 CFR, Part 280.33, "Repairs Allowed".)
- All impressed cunent systems must be inspected every 60 days to see that they are functioning
properly. lnspections must be logged (documented).
- Within six (6) months after initialtum-on of an impressed current system, it is required that a
General Survey be conducted and any necessary adjustments made.
" To meet minimum regulatory requirements. lt is good practice to conduct such surveys
annually.
APPENDIX: TEST PROCE\URES 05/03/01
APPENDIX: TEST PROCEDURES
ln order to determine the effectiveness of the cathodic protection system, structure-to-soil
potential measurements were performed at representative locations thrbughout the subject area.
These measurements were collected after the cathodic protection system was energized. These
measurements are then evaluated to determine if an adequate level of cathodic protection has
been achieved.
The two (2) most common criteria for cathodic protection as established by the NACE
standard RP-02-85 "Recommended Practice - Controlof ExtemalConosion on Metallic Buried,
Partially Buried, or Submerged Liquid Storage systems" are as follows:
1. A negative (cathodic) voltage of at least 0.85 volts as measured between the structure
surface and a saturated copper/copper sulfate reference electrode containing the electrolyte.
Determination of this voltage is to be made with the protective current applied.
2. A minimum negative (cathodic) polarization voltage shift of 100 millivolts measured
between the structure surface and a stable reference electrode contacting the electrolyte. This
polarization voltage shift is to be determined by interrupting the protective current and measuring
the polarization decay. When the cunent is initially intenupted, an immediate voltage shift will
occur. The which to measure polarization decay.
These potential measurements were obtained, utilizing a copper/copper sulfate reference
electrode and a Fluke, ModelST Digital Multimeter.
=4*
^^
July 12,2000
Mr. David Wilson
State of Utah
DEQ/DERR
168 North 1950 West
Salt !ake, City, Utah 84114
RE: 7-Eleven #25030, 17 E. Main St., Delta, Utah
Facility lD #2000138
Dear Mr. Wilson:
Per your letter of June 26,2000, enclosed is the documentation requested for the
above referenced site. Specifically they are:
o Statistical lnventory Reconciliation (SlR) Reports-Last 6 months
you have any questions please do not hesitate to call.
,
Bob DeNinno
Environmental Manager
BD:rr
Encl.
--
,.-,'1
I Et'tvrR0tu,nrruTAL I?ESPLNSE & REMEDIATI0N
JUL I 7 eOm
Enviro.mental Services Department I 10220 S. V. Greenburg Road I Suite 470 / Portland, Oregon 97223
Phone [phone] / Fax [phone]
Michael 0. Leavitt
Govcrmr
Dianne R. Nielson, Ph.D.
Execulive Dircctor
Kent P. Gray
Director
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
16E North 1950 West
P.O. Box 144t40 RS^
Saltlake City, Utah li/.ll44t/i0 - l-'F r ' -(801)536{lffiVoice 'VEn(801)359-t853Fax JUN"^ -(t0r)s36{4r4r'D'D' F^.-'
'<82000
Envit
Date June 26,2000
r1nmenbtserylbes
TO:
RE:
7-Eleven,lnc.
Attn: Bob DeNinno, Environmental Manager
IO22O S.W. GREENBURG RD.
STE.47O
Portland, OR97223
Non-compliance of underground storage tanks at 7-Eleven #25030 ,17 8,. Main St., Delta, Utah;
Facility I.D. #2000138.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and federal
UST statutes, rules and regulations.
Please send the following information to complete a compliance review, performed on May 3,2000:
Submit evidence that proper monthly release detection is performed on USTs #1.2. & 3 by submitting
the last 6 months of Statistical Inventory Reconciliation (SIR) records or another valid form of release
detection
Please return a copy of this speed memo with the above items to speed processing by August 2512000. If you have
questions concerning this matter or need any assistance, please contact David Wilson aJ [phone].Dg
FACILITY NAiTIE Station: 1852 - 25030
TANK
LOCATION
Addrass: 17 EAIiTMAIN ST
DELTAUT 81624
Fhono:
County: IVULLARI)
TANK OWNER
Namu ?-Eleveo, Iuc.
Addregs: 27ll North llurkcll Ave-
Dallas, TX 75204
Phono: (214)82&7805
County:
JUN-3Z-2AAZ 15t22 THE SUUIHLHN! LUr<r.6lh Ot4 OIr i T.uc/ u-. Statistical Invrtory Reconciliation ('-R) Monthly Report
7-ELEVEN, INC. - lggg
May,2000
Qurntitttivc Metbods:
l. A lenk threshold. uialmum dotccteblc leak rctg eud culculatcd leok rotc rnust bo providod for cocb tnn&. Ifnot, tban the
innk feiled tlrc SIR. tcst
2. If the celculatcd lcali rrtr for r teql( ir gcotcr thrn or equal to thc lerk thrcrbold, dre tauk frllcd the SIR i.ccL
3. If the uinimum dcte.cteblc hrk rnte for o tonk io greater tlrarr thc crrtificd pcrformancc stnndrrd (0, mb) ond thc celculnbd
lcok rutc iu lesr 6au tbc lcak thrxlrold, Orc tcst is incouclu*ivp for tbet moa$.
USTMAN Contact Jemes O*agu
Signature (optional)Prlnted Date: 06/30/2000
SIR Provider:USTMAN Tcdrnologie* Ilc.Phone: (309 986{0fl
SIR Verglon:952a ReportDatc 06n5n000
Pcrlod Covered:May,2000 Roqulred number of urablo lnv.niory dryc per lrlrlc 30
Quantitetlvr Mcrhod Thls Monrh Lmt Monih Two Monthr
Ago
Tcnk
Number
Tank
Cont ntt
Tank
Crpecity
Lork
Throrhold
Cdcuhbd
Lerk Rato
MDL Prss. Frll.
lnconclurlvo
Pasr, Fril.
lnconcluslvc
Pur. Fdl,
lnconclurivo
Gullonsr GIE GPH CPE PF!P F PFI
I MUL ,0000 0.10 4.04 0.05 x x x
2 RUL 10000 0.r 0 0.00 0.07 x x x
J ,PUL I0000 0.10 0.08 o.tz x x x
FACILITY NAME Stnlon: 1E52 - 25030
TANK
LOCATION
Addrer:: 17DASTMAINST
DELTA.UT 8162.
Phonr:
counry: MILLARD
TANK OWNER
Nrma: 7-Elcrre\ Inc.
Add?ott: 27ll NorrtEsskdlAve. Phone: (214) S28-?805
Dalles, TX 75204 County:
4rt Ei- i;rt' Statistical Inrnrtory Reconciliation (fu.) Monthly Report
7-ELE\MN, INC. - 1899
April, 2000
Quuntitative Methods:
1. A leak thrcclrclrt minimum dctect ble leak rotg arrd calculated lce* r8tt aust be provided for crch talh If rrol tLto the
tnnlc failcd Oc SIR, tert
2. If tlre cotculutod ioak retc for a tauk ls grcubr than or c4ral to thr lcak tbreshold, thc tnok failed ttre SIR tcst
3. If Oe rrrlrrtraum detcctrblc IcaI ratc for t tnnk is grettcr tharr the certfied perforrornce rtoodcrd (02 Sph) :rud thc sdcuhtcd
leak rotc lc lci$ tbeu the lcok tlrrglrol4 the lrst is iucorrclurive for thot uonth.
USTMAN Contact Janrer Oscuge
Signature (optlonal)Printed Date: 06/30/2000
JUN-3a-ZAAZ 15t23 ine :uutr1LHN! uuKr.
SIR Provlder:USTMAN Tuhaologieg Inc.Phone: (303) 986€0lr
SIR Vorrion:95.2e RcportDlto: 05/15/2000
Porlod Coversd:April,2000 Roquitad number ofutrble invontory dty3 per t!hk:30
Quantitailvc Mottrod Thl3 Month Lest Month Two Mont{re
Ago
Trnk
Nqmbcr
Trnk
ContenG
Tank
C!paclty
Ls0k
Thraghold
Cllcuhiod
Loek Rrte
MDL Prcr, Fdl.
lnconclugive
Pers. Fdl,
lnconclueivr
Pace. Feil.
lnconclusive
GoU,otls GPII GPH GPtr P F I P F PFI
I MII 10000 0.1U 0.00 0.06 x x x
2 ,l(ur.10000 0.t0 0.00 0,06 x x x
3 PUL I 0000 0.10 4,04 0.10 x x x
TOTRL P.B3
ru,v-t3-zaaa 15:54 214 841 b'(c ( r .oz./ 0o
7-ELEVEN, INC. - lggg
Marchr 2000
Quautitative Met[ods:
l. A lerk tlrcslrolrl, mlnlmum dctect.blc lcrl( rrtc, rnd celcuhtcd lcek rete uust bc providcd for coch trnl. lf Dol, tbcu the
tenk failed rbc SIR tqst.
Z. If the calcuhtcd lcsk ratc for n tlnk is tratcr thrn or cqurl to tba lcrk ihrcshold, ttc teok feilcd the SIR test
3. ltthe minlmum dctccttblc lcoti rrlc for a tsnk ls grcatcr ttro tle ccrtificd performence ttand.rd (0.2 gph) rnd thc celculrtcd
Icak rate is lass then tlre lcrl< tbrcshold, thc tcst le lnconclusive for tbat moatb,
USTMAN Contact Jamer Oscnge
Signaturdoptional)Date: 06/13/2000
.|3-AAAA 15:54 THE SoUTHLRND CoRP. 214 t14L o'r4r r.o1./00
n (slr) MonthryRdfJfr"
FACILITY NAME Statlon: 1 852 - 25030
TANK
LOCATION
Address: ITEASTMAINST
DELTA, UT t{67A
Phone;
Countlr: MIIJ.ARD
TANK OWNER
Name: 7.Elevca, Iuc,
Address: 271 I Nonh Hsskcll Avc. Phone: C2t4) EZE-7E05
Dallu, TX 75204 GountY:
SIR Providef:USTMAN lndustrlcs, lrc.Phone: p03)986-8011
SIR Version:95.24 Ropoil Oalo: 06/13/2000
Period Covered:Much,2000 Rcguired numbcr of usablc lnvenlory day6 por tank:30
Ouantltatlve Melhod This llonth Lasi Month T\ro Monthc
Ago
Tank
Number
Tank
Contents
Iank
Capacity
Lcrh
Thresholtl
Calculetcd
LeEI Ret.
UDL Pass, Fall,
!nconclusive
Pasa, Fail,
lnconclusive
Ptss, Fail,
!nconclusive
GALLON GPI{GP}I GPH PFI PFI PFI
I MUL r0000 0.t -{t.0t 0.(D x x x
Itt,t-r 0000 0.1 0.00 0.I6 x x x
3 PUL 10000 0.1 -0.Lr 0.06 x x x
JUN-13-2AAA 15:54 THE SOUTHLRND CORP. 2L4 84L b-Ai r.lstYto
Statistical Inr atoty Reconciliation (-rR) Monthly Report
7-ELE\{EN, rNC. - lggg
February,2000
Quantltadve Methods:
l. A' leak thrcshold, minimuu deiectrble telli rtte, and calculated lcrf rnte must bc provided for cach tenlc lt uoq thcn thc
tank failed t[e SIR tett.
2. lf the calculotcd lcek nte for ! tsttk is E:cater t[r! or cgu.l to the lcak thrcslrotd, the trnk frilcd thc StR tst.3' [f the mlnlrnum detccttbls lcak ratc for a tlnk is greatcr thrn the ccrtlficd pcrfonnolcc strudar.d (0.2 gph) eod thc calculated
leak ratc ls lcsr that the lcek 6rcshol4 thc tcst is ioconctusivc for urot roath.
USTMAN Gontact Jemcs Orcaga
Signature.(optional)Date: 0611312000
Adtlress; 17 EASTMATNST
DELTT! UT 84624
Phone;
Goun6r: MILII\RD
TANK OWNER
Nams: 7-Elcvca, tnc
Address: 27ll Norrh Harkolt Ave- phone: El4) &lt-7t05
Dsllas, TX 75204 County:
SIR Provlder:USTMAN Industrtcq Inc.phone: (303) 98e80ll
SIR Vcrslon:95.2t ReportDate: o6ngn000
Perlod Covered:February, 2000 ln"e,ri.o*nnu"rofueabtei*ffi
Quantitailve Method Thlc ilonth Last Monlh Two lllonurs
Ago
Tank
Number
Tank
Contenls
Tank
Capaclly
Leak
Threshold
Calculated
Lod( Rate
iroL Prss, Fall,
lnconcluslve
Pass, Feit,
lnconclusive
Pass, Fail.
lnconclr.rsive
GALLON GPH GPH GPH PFI P F !PFI
I MUL 10000 0.r -0.07 0.09 x x x
2 RUL 10000 0.1 -0.01 0.06 x x x
3 I,UL r0000 0.1 -0.02 0.05 x x x
JUN.13-2AAA 75:54 THE SOUTHLRND CORP.
Statistical Inv.)to.y Reconciliation tJU Monthly Report
7-ELEVEN, rNC. - lggg
Januaryr 2000
Qusntltstlvc Mctbods:
l. A leek ttrcslrold, mlnlnum dctcctrblc lcek retc, end crlcubtcd leek nte must bc providc4 for eecl tatr|(. If noq thea ttc
tuk failed thc SfR scsL
2, If the calculsted le3l( rrte for r unk is grcntcr thrn or cqual to ttrc tcrk thrcshold, tbc tank failed thc SIR tcst3' lf the mintnum dctccteble tcrk ntc lbr a tark is grc.ter tban tlrc ccrtificd pcrformroce standerd (0.2 gph) ead the crlculrrcd
lctk rrtc is lers ttrea thc letk ttrcshol4 the tcst iJ iEcoDclusivc for thlt Eoath.
USTMAI{ Contact James Osatge
Slgnature, (optionat)Date: o6n3t200o
2L4 a4I o(;.tt r.aq/0o
FACILITY NAME StBtion: 1852 - 25030
TANK
LOCATION
Addrcss: 17 EIIST MAIN ST
DELTA, U',r tMU
Phone:
County: MILLARD
TANK OWNER
Name: 7-Elcvcl, Ioc.
Addruas: 27ll North Enskcll Ave. phone: (2r4) E2E-7E05
Dallas,'fx 75204 County:
SIR ProYider:USTIUAN Iudustries, Inc.Pionc: p03) 986-80II
SlR Version:95.2t R.poiDare: 06fi3tr,;000
Perlod Govercd:January 2000 Requlrod number of ucable inventoqr daya par tank:30
Quantltatlye Method This Uonth Last illonlh Ttro tlonttr
Ago
Tank
Number
Tank
Contcnts
Tank
CapadV
Leak
Threrhold
calculato.,
Leak Rate
MDL Pasc, Fali,
lnconclusive
Pass, Fell,
lnconcluelve
Pass. Fail.
hcondu3ivr
GALLON GPH GPH GPH PFI PFI PFI
I MUL 10000 0.t {.08 0.Is x x x
2 Itut.10000 0.t .0.06 0.0s x x x
3 NUL t0000 0.1 -t.09 0.1t x x x
Michael O. Leavitt
Govcrna.
Dianne R. Nielson, Ph.D.
Excsrlivc Director
Kent P. Grav
Diredr
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF EIWIRONMENTAL RESPONSE AND REMEDIATION
16E North 1950 West
P.O. Box 1,14840
Salt Lake City, Utah 84114-4E40
(t01) 536-410 Voice
(E0r) 359-8853 Fax
(801) 5364414 T.D.D.
TO:
RE:
Date June 26,2000
7-Eleven,lnc.
Attn: Bob DeNinno, Environmental Manager
IO22O S.W. GREENBURG RD.
STE.47O
Portland, OR97223
Non-compliance of underground storage tanks at 7-Eleven Y25030 ,17 E. Main St., Delta, Utah;
Facility LD. #2000138.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and federal
UST statutes, rules and regulations.
Please send the following information to complete a compliance review, performed on May 3,2(XX):
Submit evidence that proper monthly release detection is performed on USTs #1.2. & 3 by submitting
thelast6months of Statistical Inventory Reconciliation (SIR) records oranothervalidform of release
detection
Please return a copy of this speed memo with the above items to speed processing by August 2512000, If you have
questions concerning this matter or need any assistance, please contact David Wilson at (801) 5364100.
l. Ownership of Tank(s)ll. Location of Tank(s) ,-
lll. Tank lnfofmation Complete lor each tank. lf lacility has more than 4 tanks, complete inlormation for additional tanks on separate form.
Number ot tanks at facility:
Current year tag is displayed
Tank presently in use
lf not in use, date last used
lf not in use, depth of product in tank (in inches)
Month and year tank installed
Capacity of tank (in gallons)
Material of construction of tank (steel, FRP, etc.)
Material o, construction of piping (steel, FRP, etc.)
Piping type (pressure, suction, gravity, etc.)
lV. Release Detection For Tanks lndicate the method(s) used for each tank. Complete the appropriato checktist for each method used.
Emergency Generator tank (leak detection defened)
Method used (enter method used and complete appropriate form)
V. Release Detection For Piping lndicate method(s) us€d and complete appropriate tank checktists where appticable.
Method used (complete separate torm where applicable)
Automatic Line Leak Detector type and model
Date of last Leak Detector performance lesl
Date of last Line Tightness Test
Name and company of certified tester
No leak detection required (must answer'yes. to all questions below)
Operates at less than atmospheric pressure
Slope of piping allows ALL product to drain into tank when suction is released
Has only ONE check valve, located directly under pump
Above information is verifiable; use comments section below to document how it is verifiable
lnspecto/s Signature:
Present During Inspection:Signature of Owner or
UTAH UST PROGRAM
Release Detection I
Faciljly lD No.. 2 aAA t aA
n Checklist hf'*. { ( ^*Rq
Distribution: White-DERR, Yellow-lnspector, pink-Facility/Orwner Revised Z4l99
(.-
Spill, Overfill,
UTAH UST
and Corrosion
PROGRAM
Protection lnspection
Facility lD No. J ooat g8
Checklist
Please complete all information for each tank. Use additaonal forms as necessary if the lacility has more than 4 tanks.
SPILUOVERF|LL PREVENTTON .,\ ;
Tar Tah( 2'T t/Tank 4
ls the UST system is filled by transfers of 25 gallons or less? lt yes, spill
and overfill prevention is not required.Yes @ Yes @ Yes @ Yes No
ls lhere a spill containment device that will prevent release of product into
the environment? lndicate type: Spill bucket <5 gal., Spill bucket >5 gal.,
Containmentsumpattankfill.
-
re! No @) No @No Yes No
ls there an overfill prevention device installed on the tank? lndicate type :
Ball float (in vent line), Automatic shutoff (in fill pipe), Alarm, or Other
-
(specrrv)
Yd, No @No WNo Yes No
For overfill alarm only: ls the alarm located where it can be easily seen
and heard by the delivery driver?Yes No Yes No Yes No Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?Yes No Yes No Yes No Yes No
CORROSION PROTECTION
Tanl(L/Tanl Tanf 3 Tank 4
lndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrificial Anode
Tank<A Tank
<A
Tank
<.a,
Tank
(SA), or Not prolected (NP).Piping
Ar'*l
Pipingt/n Piping
,YA
PiDirc
lndicate the type of corrosion protection on Flex connectors and/or Swing
ioints: Booted (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically prolected (CP), Non-metallic (NM) and Not
Protected (NP)
Sub-PumpA Sub-P!mpA Sub-Pump
t4
Sub-Pump
DispenserA Dispenserft\Dlspenser
/A
Dispensor
Tank lining
lf tank or piping has been
upgraded, indicate date Tank cathodic protection
upgrades were performed:
Piping cathodic protection
CATHODIC PROTECflON TESTS Record results of the most recent cathodic protection test. R€cord the lourest readino lor each tard<loioirxrlflex sel.
The results of the last two cathodic protection tests are available. (within
6 months of installation and every 3 years thereafter).@No @No @No Yes No
-k-raii. tester 7an)llaalnay o"rc?-?f-?t 1q, N',n"7L, &r'""*11g 44^*volls
Pipinq. Tester Date ,r'+ vorrs i* votrs //* vorts volts
Flex. Tester Date
Sub-Pump
lt/L votts
Sub-Pump
,/1 vors
Sub-Pump
-t/l votrs
Sub-Pump
volts
Dispsnser
,/" votrs
Oispenser
,L vors ,,/L votis
Disp€@r
volls
For impressed currenl system: The results of the last three equipmenl
operalion checks are available. (Equip. check required every 60 days.)Yes No Yes No Yes No Yes No
co ^"nt",*./-a.s* -fr-oo '/zcJq n^larq att s7 l<-- TouiQS;l-d;L**. ,^r^.
lnspector's Siq6:^.>--.,4.Date: t- 5:;;
Signature or O*n"
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Ldspillover.wpd 2/99
t UTAH UST PROGRAM Facitity tluo.3atu t hi
Automatic Tank Gauging
Manufacturer, name and model number of system:
Please circle Yes or No for each question lor each tank I racllity has morc than 4 tanks, complete lnrormatton ror additionat tanks on
separate form.
v*@ u*@ ran@ Tank 4
Device documentation is available on-site (e.9,, owner's manual).6) No @No ffi) Ho Yes No
Records on site document that the system was properly installed and calibrated (system
and iank setuD reDort).@No @No @No Yes No
System is maintained in accordance with manulacturer's instructions(records are
available on site).
@No @No @No Yes No
The probe is located at the center of the tank. lf no, indicate tilt correction factor from
tha tank cehrr.l renori @NoTilt: 4.-Ar @*,Tilt: t.4 @NoTilt: .t Yes No
Titr:
Device can measure the heioht of the oroduct to the nearest 1/8 of an inch fe No (@ No GA No Yes No
Device monitors the in-tank liouid levels over the full ranoe of the tank's internal heioht ,f,iU No it6 No GJ No Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the
device is eouiooed with roll of oaoer for results documentation)@No @No @No Yes No
Documentation is available demonstrating that the Automatic Tank Gauge performed a 1valid leak test at least once a month lor the last 12 months
ves@)v"" @ t"" @ Yes No
lf no, lor which months was a valid test not performed? (specify months and year, ,"" *
soace below if necessarv)
d*ly tfl
The tank was lilled to at least the minimum level required by the manufacturer's
eouiDmeni orotocol to ensure a valid leak test @*"@*o @*'Yes No
The lank capacity is within the upper and lower size limits required by the
manufacturer's eouioment orotocol to ensure a valid leak test @No @No @*.Yes No
Have any ol the leak test reports indicated a failed test? lf yes, specify in the space
below the month. vear. and what follow-uo actions have been taken.
t"" @ Yes @ Yes @ Yes No
Documentation ol performance claims for the automatic leak test fealure is available and
shows the ability to detect leaks of 0.2 gph with 95o/o or greater probability of detection
and 5o/o or less orobabilitv of false alarm (3rd Darty certification).
@No @- No @*o Yes No
lndicate month(s) ot invalid or missing test:+-y* t
T*lv clg t /Yaf, qa
Ai 4r, I)a-e- 4iel
t T"tt 2 ooo '^ At( . n*lr.-r u,ta,
,r/^r had Pa.<t;r^qf4
t? f l*z .*fig.,;Lu^ F.n qi , So -ooa ,o nl F--L . Atl a*ho* y'at&
,""r-r"r'tra"^,7 il) \ \ \---
l1w aatA aat a.--..\#or-.ahr nr,i h^ lncQianalrrra ^t nwh6t
Oistribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Revised 12\95
jg'EPA untted statos
^ Environry,Blllo!91!9l Asency i\ Washtngon. DC 204G0
Fonn ADorovec
OMB No 205GOO68
Notification for Undergr ound Storage Tanks
,'tate Agency Name anc, Adctress: I STATE USE ONLY
ro NUMBER: z_aq9JEK
DATERECETvED: A/n/(Y
DATE ENTEBED rNro coMpurEF: '6 I Lql@
En. r.rewFAcrLrw -/lEa. N're^roEo lI c. c.osrne
DATA ENTRYCLERK INITIALS:
UV--J Numberollant$€ attacll,ty
_ Number ot continuaion sheeE athched OWNEH WAS COiITACTED TO CIIEIFY RESPONSES. COI{MENTS
lllllIlltlIL'fr
I Ptease VDe or Dnnt rn ink . AEo. be sur€ lrou have stgnat res n ink ror sectons
I Vlll and Xl. Compl€t€ a noliicatbn brm toreach location oontaining
I underground storage tslnks. It more than S tanl€ aI€ o^,ned at this t6caton, pt,
I may phorocopy pages 3 rlrough 5 ancl use them icr actclfional tantG.
I
I The pnmary purpose ot this nolification progEm ls to locate and araluate
underground storage tank systems (usrs) that stor€ or have stored petroteum
or hrTardous substances. The inronnaton you pro\ride will be basect on
reasonably avalable records, or in tne aoserre ol suctr reoords, your
knowledge or recolloctofl .
Federal law rcguircs UST ownsrs to ure this notftc'tion lorm ior all
9_1T: "tqf,lg regutatcd subsrances ttat arc brought lnto use aftcr May a,
1986,. or USTs in the grouncl as ol Mly E, l$6 tlral hwc rbr.d r.gubildaubalances at any tirne rincc January i, 1974. Tho intodmtion
?Egu.stcd ls rcquircd by Scc-tlon 90(l2l ot trc B.rource Conrcwation andRccowry Ac? (RCRA), Mnendcd.
Wtr_o Must Notity ?Secton 9002 of RCRA, as arnencled. ieguires ownars ofusrs that store regulat€d substances (unl€ss exemBed) to nitry oesgnrateo
Stale or local ag€ncies of the exrstence of their USTS. lu*ref is OennEO as:
' rn the case ol an UST in rce on November g, 19E4, or bought into us€ att€rtt3t da!e, any person who ori,ns an usT us€d br storagE. use, or dispensing
of regulatec, subsitances; or
. h the case ot an UST in use Detore Novemb€r g, 1g&4. but no longpr in use
on that date, any person who owneEl tle UST immsdiat€fy Oetore G
drsconinualton.
Also, it the srate so reguires, any hcilrty that has made any changes to racillty
informatron or UST sysrem status, muat submit a nolificat;n to# lontyamended inrormaton needs to b€ tndud€d).
What USTS Are lncluded ?An UST system ts defined as any one or
combrnation of tanks that (1) B used to contain an am.rmulaton ot regulatecl
substances, and (2) whose volume_(including connect€d undergrounj piptng) is
1096 or more beneah the ground. Regulated-USTs gore petroleum or
'
hazardous substances (see the tollowrng nVhat Substances Are Covercd).
Wllttfmks Are Erclurtcd Frcm Notllication ?. Tari<s
'Bmored
tom th€ grcund b€tol€ May 8, 1996:. FamorrBsi(lenlial bnks-of f.tOOgattonso'r,fess.aoacrtystonngmororfu€l lor
noncommecal purposes;. TanlG stonng heatng otl tor rse on the premEes u,here stored:. Septic tantG:. tipelin€ taqlfies (indudtng gBthenng tines) regutated unO€rlhe Natural GasPipelin€ Satsv Act ol 19O9. orttE Hazardous Lrqurd ppetrne Saterv Act ot
1979, or wlricti ts an intrastate ptpetin€ tacif,ty regutated under SUile Ews;. sudace impounctments, plts, ponds, or lagoons:-. Sorm water or waste waler coilecton sysims:. Flow.hrough piocess tanlc;
' Ltqrd traps or assochled gEthenng hnes directy related lo oil or gas producton
and gah€nng operations;. TanlG on or abo/e lhe n@r of underg]ouncl areas, such as bas€ments or
lunnels;. Tanks wiih a capactty ot f 10 gEllons or l€ss.
Whlt SuBtancrs Arc CotGGd ?The nolifcation requirBments apply b USTS
containrng petroleum or certatn hazadous substances_ petoleum rnauiOes
gEsoline, used oil, desel fuel. crude dl or any tiacton thereol wtrich rs liquid at
stanclaEl conditions ortemperatrre ancl presiure (60 degrees Fahrcnhei and 14.7pounds p€r
Soclbn 101 (14)
and Liatflity Act ot
reguebd as
WhcreTo ifouy
Whcn To Nodty ?
operation after
2. Oumes rvho
1986.
ch),sof bnngng tre UST
amendndnts o raarnv, s"m- iiioffidffi ;ffi 'fi#yffiUifi]
Pcrulllc : Arry ou,neru,ho lglowngly bils to ndty or strnils tsEe infornslrrn
sftel_l be $/!i€ctb a cMr p€nerty mt 6 exce€d $ri,ooo tor each ErI( brwtriirnolificalixr is not grven orbru,hich hbe inbnnalion is g,\rEit.
JUN I 4 2000
, Ornee ol USTs in use ortlat lrave been tEken
bul slifl rn the gound. must
Owner Name (Corporaton. hduidual, p\6I6 Agcflcy, or olhcr Entty)
;,.",^..,r* 7-Elevgn, lnc'
Gasoline Acctg.
P. O. Box711
Dallas, TX 25221-0711
Countv
,-, r*yl{y Slare, gve lh€ g€ographrc tocatpn o, USTS by d.9rt6, ,ilnucs..nds6conos. ErampE: l3mu(b 42 . 36, 12. N, Longtude g5 ; Zl,1t. W
urtudo_ bfigihd._
Faolrty Nam€ or Company Srte ld€nther. es apptEabE-f -LutvrN + Lbc,Zo
E It adlrcss rs the sarae as rn seco0n l. check the box and proc€cd ro s€cnon il.ll a(tlrass rs dillorsnt. enter aoldrass belouy:
Str.er A(hrcss\nEf\sT MA\N ST
"** M \ LLA,q_{-r
Crty Surre Zp Cooe
Phone Number (tnctude Arsa Code)
EPA Fom 7l?rtl ,E.v @ I Era^.h^.^
cty
-\),6LTn Slare
rlT Zrp CoOet'{tsZl"{
5ll.!op+53&t (Rrv. 9{8 ) Elecrronrc anct paper versrons acceptable.Frevrous edttrons may be used whtte supptl€s last Pagetd5
" Notification for Underground Storage Tanks
T
tr
n
Federal Govemmenl
Sbte Go\r6mm€nt
Local Gorgmm€nl
USTs are located on hnd within an lndian
R€s€n,alion oron trusl hncls outsire
Ies€n,albn boumhies.
USTs are oumect by a MWe nmencan
naton or fibe.
Tribe or Nation wfi€re USTS arc located:
Gas Slation
Petroleum Distribrnor
Air Taxi (Ai,tine)
Aircrall Oivner
Aulo Dealership
f n"i,ro"o
D f"O"o,. lrlon-Military
D reoerat- Military
D ,no**
E con**,
I r..*,ngrrr€rnsport
D uuN".
I n"s*n,",
I r"-
{I
Ir
l
Job Tite:
Environmental Manager
Acklress:
7-Eleven, lnc.
10220 SW Greeburg Rd #470
Portland, OR97223
Phone Number (lndLde Area Cde):
Phone: (fi3) 972-TT1AFax: [phone]
Check All that Appty
!J Selt lnsurance
e,lfrCommeroal lnsurance
I n,.x Ber€nton Gloup
i i Local Gwemment Finanqal Test
iJt have met the financial responsibility rBqJitements (h accordance with 40 CFH Su@ri H) by using the lolltrving mecfianisnrs:
E o*-**
E surety aono
[11 Leter ot creoit
I aoto Rating Test
I staprunas
E rru$runo
[} OnerUetroO (descdbe hera)
subrflllted .n S€c-tions I |hlulgh Xl o, this nofficalion bm and all
br obtaining lhe int'cnnatton, I b€liaro lhet lhe $brflm€d htornalXxt
I certtly und€r p€nalty o, hw lhal I h8w pqEonaly €xlrnirql and arn famalar udth fle
attactred doorm€nE. and that bas€d m my iquiry ol ttGe in(llrld.l8ls immediaicly
is true. a61rrale. and complgte.
Name and olficral ti0€ ol owner or o ,n€fs
authonzed represenlalive (Prinl)
Bob DeNinno
Environmental Manager
nolilicatron lorm may b6 used whrle supghes last.
\w^
\?EPA
EPA Fonn 75OOl (R.v. 9€!) Eledronrc anc, paper verstons acceptaDte
Prevrous edttaons may be usrc, while supplEs lasl.
\, Uniled StaEs
Environmental Protection Agency_ Washrngron, DC 20460
Fonn ApP[oveor
OMB No.205GOO68
PaoE 2 ol 5
un[rd sl,.l.stnviron rrental Protestion Agency
Washn$on, DC 2(x60
1 Form Aooroveo.
OMB No 205&0068
Notification for Underground Storage Tanks
TankrdentficationNumber lTankr,b.LiTankr,,b.4 |
1. St ius ol Tank (cfred( mV one) Curreflty h Use
Tempoadty Ctosed
permanentry Closed
K
D
tr
il
tr
D
rttr
D :r
Z Dlbo,tnrttlltnon (monf4r€a4 /l?s{/ //?8/ I
/0 lto
4. Mltcriel o, Constucuon (ch€ck ail that apply)
Asphall Coated or Bare Sleel
Caflodtcab, Protected St€€l
coated and cafpdicatty promaed steet
compo{rte (stteet ctad wih F,b€rghss)
Fibergilass Reintorced plestic
Linecl lnterior
Euvalhn Liner
Double WaI€d
Pq/EfU€n€ Taril(Jad(et
Cmctete
Unlmouyn
I Oher, ploase sp€crry here
Check box it tank has wer b€on rBpaircd
-V
tr
tr
tr
tr
tr
tr
tr
tr
tr
Y
tr
tr
tr
tr
tr
tr
tr
tr
tr
"ra
tr
u
tr
tr
tr
D
tr
tr
tr
=J
-i--1
J
J
:']Jr
tr
r-.J
-
-r
-
!
t:
-']
T
r'"r
LJ
5. Piping Mercrilt (chGck !l! thlt eppty) BarB Steet
Garvanized Steel
Fibergtass R€in orEed plasirc
Copper
Carlodcafyplot€cfed
Do!6aeWald
Ssfary Contairnent
tre/
tr
tr
tr
tr
tr
tr
D
{
tr
tr
tr
D
tr
trV
tr
tr
tr
tr
n
DI
tr
tr
tr
tr
tr
tr
I
D
!
D
!
tr
tr
tr
6. Plping Type
(Check ail that appfy)
"Sate' Sudi)n (no tai,3 al trr{()
lJ.S." Suclion (valve ai tsr{()
presqrre
Gra,ity Fe€d
Check box il ppng has eirgr bs€n,Epemd
tre/
tr
tr
n
e/
tr
T
trV
tr
tr
tr
D
tr
tr
!
tr
tr
tr
D
tr
EPA Form 753G'1 (Fcv. $tS_) FParon,c ano paperwepns acceptDte.Preuous edtbons may oe useo'unrr srpries,ae-- '-PagE 3 ol 5
9EPA \z unrt€d Stales -\-
Environmental Protection Agency oua N,o.zo-s+oilsa_ Weshrngnon. DC 2O't50
Notlfication for Underground Storage Tanks
Tank ldentificaton Number Tank l.,lo. L
l^
I fanr. rrr. 41 I---j ranx tro 5 Tank M Tank tvo
7. Substlncc Cuncnty Stor.d (or hst Gasdine
storld in lm casc ol cbrcd tanks) Diesel
( Ch€ck all tlat appty) Gasohol
K€rosene
Heatng Ot
Us€d Oil
l:*::i""**:::
HazaEbus Substance
CEBCI-A narne ancyor
CAS number
s
tr
T
n
T
K
D
tr
tr
D
tr
,r:
I
:J
#-
rliJ
rl i:-]J
r-ii-
-
-.]
i
-I
I/t
{
_--
I
i
{
Mixture ol SubsterEes
Pleass sp€cily here
i-]
i 8. Rdasc D$ction (check all rlat apply)
| *uatrankgBugmg
Tank tighhess testing
Inwrtory Confol
Autornatc tank gaugmg
vapor monitonng
Grounch/ater monnonng
hterstilbl rnonito.ing
Aulornalic line l€ak Cbteclols
Lrn€ tighfrross tssling
No release cbtec{bn r€qrit€d (sidt as sfli€ ty?€s ot
suclion piptng, emergency gpnerebr tanas or fi€kl
conshjcl€d tanl(s)
Ofi€r methocl alow€d !y impl€rn€nlhg agerEy
($rcfr as SIB)
Pbass sp€dfy oh€rmetlql hsre
TANK
tr,
tr
trd
I
I
T
tr
{
tr
tr
D
D
wd
x
P|PE TANK I HPEtrltrl
"/trtrlntrlntrlel*lvtr1.
ill
TANK
tr
tr
tril
tr
tr
T
t
tr
tr
D
T
Dtil
T
PIPE TANK
tr
tr
T
tr
i
tr
tr
D
T
PIPE
D
tr
D
tr
tr
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tr
urx I HPEtrlrltri!lntrlntrlnDln
lnItrDln
r lr\<lk }ITL
9. Spill and o'rcrflll Probctlon
Oy3 lill d€\rics instaIed
Spill d€rrice rrrstallecl
tt/r-J
{
/.B/#D
tr
tr
tr
EPA Form 7silo-l (Rcv. 9€E) EEcrronlc and paper ve'stons acceptabte.
Previor.rs €dilions rnay be us€d nhile s.ppbos l8st.
Pagp4 ol5
Unned S|ates
Environ mental Protection Agency
Washrngton, DC 20460
Notification lor Underground Storage Tanks
ranr ruo.
-
i rTr No.
-
I ranr rrn i ranx r.rc lr"nx ru"
1. Clrsun or Chengc ln Scrvicc
Estmated date trle UST rrvas tast us€d brsbnng regtdaEd
substDc€s ( monw@y/year)
Ch€ck box it lhis is a change in s€Mce
2. Tank Closure
Eslirnated date tank do6ed (npnwday4/6ar)
(ch€ck alt fl8t apply b€t4r)
Tank was rmorccl lrom ground
Tank was dos€d in ground
Tank flled with in€rt ]rlaterhl
Describe the inert fill rnaterial hor€
J
LJ
,l
J
L]
SiE AgscssrEnt
Check box ilthe site 2esessn€nt was completed
Check box il errijenca o, a l€ak rvas det€cted
IJ
tr
tr
tr
lnrtaltcr Ol Tank And piping Murt Ctrcck All Thet Apply:
T
T
D
trr
D
lnstaller ceriilted by tank and ptping manutactureE
lnstaller certifiod or licensed by the tmplementtng egency
lnslallatDn rnspeded by a rsgislocd ergllneer
lnstallatEn inspeded and approved by mplenrennng agorrsy
Manufacturer,s installalpn ch€cklBls lrave becn cornpbtad
Trr
!
x
tr
!
T
I
T
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tr
trr
I
tr
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IAnother rnet rod elloir€d by State aoertvI so, paecae specrtf ncr6
Signalure ot UST tnstaler Certifyng proper tnsOlbton ol UST System
EPA Form 753&1 (Rcv. $gS) Etectronrc anct paper veBons acce@UePreuous editions may b€ us€d *t t" wpptns nS Pagp 5 ol 5
OCT-22-1999 1?:39 ,ITHE SOUTHLRIID CORP. \ 2t4 A4t 6?4? P.O2/@2
7'Eleven SIR Stores Release lnvestigation and Confirmation Steps
I t\Kt-u
Facility lDl
r-Eteven, lnc.
Address Clty StateMarket #7-Eleven #
Month
EndinE Grade(s)Details1200232185123E42416 EAST 2604 NORTH NORTH OGDEN UT e/30/99 RUL PASSEO PT-I 9I2SI990'100186 1 851 25472 405 NORTH MAIN LOGAN UT s/30/99 RUL PASSED PTT 1O/2Ol9940010461 851 26591 11 EAST 17OO SOUTH SALT I-AKE CITY UT 9/30/99 RUL PASSED PTT 1011719940009s81 852 '16449 TOOO SOUTH 3720 EAST SALI LAKE CITY UT 9/30/99 RUL PASSED PTT 8/26/99e0001031 852 23471 25OO WEST 5OO NORTH MAESER9000103 UT st30le9 PUL PASSED PT-f 10t20t992347125OO WEST 5OO NORTH__MAESER UT 9/30/S9 RUL PASSED PTT 1Ol19/9S20001 38 1852 25030 17 EAST MAIN ST DELTA UT s/30/99 MUL PASSED Pfr 1OI2OI99
10t2z9s
IOTRL P.02
7.ELEVEN,]NC.Page 4
acT-22-t999 1?:38 THE SOUTHLRND CORP.
\-
Datc: Qctober 22. 1999
Phone (214>8?E-ss93
FAX TRANSMITTAL
Number of Pages Including Covcr page: !
Fn<#: (214)84t-6747 Plrone #. (2 I 4)84 l -6 592
Sincerely,
7-Eleven, Inc.
(formerly, The Southland Corporation)
ENVIRONMENTAL SERVICES DEPARTITIENT
corporate officc Cityplace Center East 271I N. Haskell Ave., I)allas, Texas 7slo4Mairing Address: p.o. Box 71 1, Daflas. Texas 7522r-071 r
\-,
21"4 A4t 6?47 P.AVAZ
lrivlRCl,lt,:EI\lTl:_ t:. SE &
:ilTCD:rLiiiL-.:-U
To: POSITION ON CALL, Utah Departmenr of Environmentaleuality
Division of Environmentar Response and Remediation. s"rt L;k;airr, u,*Fa.r #: (B0l)s36-440! or (801)35e_8853 ph"";r,-i;; \62a_4ozs
Fronr: Ken Hiltiard, Environmental Manager
7-Eleven. lnc.. Dallas. Texas
mT 22m
Re: Details on statistio,rrJ rnvcntory Reconcitiation (,.srR',) Results for September 1999*+:F***r****r++* l'.'r r*!rit +++++*****ir,+,t++**,r* **rrt++**i..*i*,r+*+**,tr ***rr+t**,r!i!r!a.++**++** *Ath: POSITION ON CALL;
7-Eloven, lnc' utilizes Statistical Invcntory Reconciliation ("stR) as the release detection method at anumber of its locations.
Recently' 7-Eleven, Inc' repofted suspected releases based upon slR data for the previous month to thisagency (Note: Not all of the sites listccl may be undcr this agency s iurisdiction.).
'lihe purposo of this fa.x is to iuform the agency as to the results of investigations and preoision tankl.esting (rvhere required).
7-Eleven, Inc' is using this reporting format in the interest of efficiency becausc of the number of sitesthat it operates.
Should you have any qucstions, please fecl free to contact me.
Attashment: InvestigationDetailsReport
Cc Vattch: Cindy Davis, 169l ilon Radle. 1g97 peggie Betz. 0l4gJohn Graves, lg5 t Andy Garcia. lg52
citlplaccccnterEast/2TtlNonhlIaskgltAv*""rnar*'|ffiigi;r*r-MuirinsAddress:lrorTlt/Ddllas,.tx7s2?t.o7lt
Facilitv lD #
7-Eleven, lnc.
Address Citv State Glede
Month End
9/30r99
Reeulte'
MOnm Eno
6t31t99
Reeulta'Market# 7-Eleven #
'1200232 1851 23842 416 EAST 26()4 NORTH NORTH OGDEN UT RUL F F
0100186 1851 25472 405 NORTH MAIN LOGAN UT RUL F F
0r001 87 1851 26577 1395 NORTH MAIN LOGAN UT RUL I F
0100187 1 851 26577 1395 NORTH MAIN LOGAN UT PUL F P
01001 87 1 851 26577 1395 NORTH MAIN LOGAN UT MUL I P
4001046 1851 26591 11 EAST 17OO SOUTH SALT I.AKE CIW UT RUL F P
4000990 1851 267-44 109 S.300 EAST SALT LAKE CIry UT PUL I P
4000E80 1 851 26794 i09 S.3OO EAST SALT I-AKE CIry UT MUL I P
4001 338 1851 27126 114 WEST 13OO SOUTH SALT I.AKE CITY UT RUL t P
4001444 1651 29514 309 EAST 4OO SOUTH SALT LAKE CITY UT MUL F P
4000998 1 852 16449 TOOO SOUTH 3720 EAST SALT LAKE CITY UT RUL F F
9000103 1852 23471 25OO WEST 5OO NORTH MAESER UT RUL F F
9000103 1852 23471 25OOWEST 5OO NORTH MAESER UT PUL F F
1000289 1852 23E5'l 1196 WEST CENTER OREM UT RUL P
4001 01 5 1852 23901 4664 S. REDWOOD RD TAYLORSVILLE UT RUL F P
2000138 1852 25030 17 EAST MAIN ST DELTA UT MUL F F
4001042 1852 25424 2287 EAST 33OO SOUTH SALT ISKE CIry UT MUL F P
4001020 1 852 25948 8OO2 SOUTH STATE MIDVALE UT MUL F P
ocT-13-1999 15:38
^
THE SoUTHLR|..|D CORP.2t4 A4L 6?4? P.A2/42,\
7-Eleven SIR Stores with Non-Paasing Result 1 0/1 3/99
Stores that heve a Repeat Failure will be followed up with an erplanation or Prccision Tank Test within 7
or 1O daye, unlece a Precision Tank Test has already been dono within the last 60 days.
* F= Fail, I= lnconcluglve, P = Paaa
TOTAL P.A2
ocT-13-1999 15:34 THE SOUTHLAND CORP.2!4 e4L 6747 P.@L/@?
\,
ENVIRO NMENTAL SERVICES DEPARTIVIENT
Corporate Office Cityplace Center East 271.I N. Flaskell Ave., Dallas. Tcxas 75204
Mailing Addres:,': P.O. Box 711, Dallas, Teyas 7522ll.-0711
Phone [phone]
F'AX TRANSMITTAL
Date: Octo.b..ef'"L3..129.9
Number of Pages including Cover Page; 2
lb; POSITION ON CALL. Utah Department of Environmenral Quality
Division of Environmental Response and Remediation, Salt Lake City. Utah
Fax#: [phone] or [phone] Phone #: (303\620-4029
From; Ken Hillirrd, Environmental Mauager
7-Eleven. Inc. (formerly. The Southland Corporation). Dallas. Texas
Fax#: [phone] Phono #: 1219841-6592
Re; Reporting of Stetistical Iovcntoty Reconciliation ("SIR') Results for Scptember 1999+++++***'|. ***tl********rl *r{.*tl**i,r *****!t**!0***+*+*++++++++*+**'t**{.+'t rl*I**rt't+**+*++++++++
Attn:POSITION ON CALL:
7-Eleven. Inc. (formerly, The Soutfiland Corporation) utilizcs Statistical Inventory Reconciliation
(*SIR") ss the roleasc dctcction method at a number of its locations.
By way of this faxed infonrtatiott- 7-Eleven, Inc. intends to inform the agency that rhe sites listecl on the
anachment are reportable suspected relenses bascd upon SIR data for the previous month. Not all of the
sites listed may bc undcr this agcncy's jurisdiction. 7-Eleven, Inc. is using this reporting fonnat in the
iuterest of tirne and number of sites that is operates.
Wbere required, precision tank tightness tests 8re being cornpleted. Results rvill be submitted to the
a8pncy whcn complete. 7-Eleven. Inc, is also anvestigating the accorrnring records and cquipment for_
possible problems.
i
i Ellvln,::... :,:ii. ._ ? .._ ._-, .:,^.1
Should you have any questions, please feel free to contact me.
Sincerell,,$t r3ts7
Environmental
Attachment:
Cc dattch:
Manager
Suspected Release Listing
CindyDavis. 1691 RonRadle, 1897
John Graves, l85l Andy Garcia, I 852
Peggie Ectz,0147
Citl'placc Centcr Eusl. / 271 I Nu(h H:rskell Avcnue I Dgllas, TX 75204A906. Mailiag Adrlress: Box 7l t / Dull1l.l, rx 7t221-O7l I
2L4tg2S-o7rt
euc-31-1999 t7t2? .-. Tt-lE S0UTHLQND CORP.
7-Eleven SIR Stores Release lnvestigation
2L4 eAL 6747 p.QltZZ
and Confirmation StePs
1157 CALIFORNIAAVE
199E N MAIN ST.
NORTH OGOEN I UT [ 7t31199415 EAST 2804 NORTH
ILF,
23s4f
487 S REDWOOD RD,
SALT IAKE CI
2321 S. REDWOOD RD
2321 S REDWOOD RD
WEST VALLEY
CITY
01 001 88
01 001 E7
i t31t9gSALT LAKE CIT
SALT I.AKE CITY
T I.AKE CITYTOOO SOUTH 3720 EAST
222 WEST 3OO SOUTH
17 EAST MAIN ST
Dotails
PASSED PTT E23l99
PASSED PlA U?4199
PASSED PIT 7I7I9g
PASSED PTT EN2I99
PTT 8/20199
REPORTED TO
UDERR 8I21Ig9
PASSED PTT 826/9S
PASSED PTT 8f26/9S
Tt gru?s
PASSED PTT 8/23l9S
PASSED PTT 8X26/99
PTT 8/26/9s
PASSED PTf EMJqI
PASSED PTT 7
PTT 8/4/99
PASSED
8/31/9s
rOTRL P.A2
7.ELEVEN,INC.Page 4
^ 1.4
euG-31-1999 L7t2? v
e,41 6?4?
rHE SOUTHLAND CORP.2t4 P.4L 674? P.OL/Ozv
Phone (214)82t-5593
FAX TRAT{SMITTAL
Date: Ausust 31. 1999
Nuurber of Pages tncluding Cover Page: 2 t:tG : I rg!,3
To: POSITION ON CALL, Utatr Departnent of Environmentsl Quality
Division of Environmental Response aud Rernediation, Salt Lake City,rUtah
Fax#: [phone] or (801)359'8853
From: Ken Hilliard, Envirounental Manager
7-Eleven, lnc., Dallas, Texas
Phone #: (303)62-0-+tt2-
Fax#: (214\841-6747 Phone #: (214\841-5592
Re: Detcils on Statittical Ioveutor-r, Reconciliation (*SIR") Results for July 1999
** 'r* * * 't *i++ t*rl.+ i.t+t ++t '|++t+:t**++++++*a+ai'lt*tt**|lt *t*t* tllttl*tt}tl.+* ++**+ *+***tlttlatatl'F|lttt
Ann: POSITION ON CALL:
7-Eleven, Inc. utilizes Statistical Invcntory Reconciliation ("SIR") as the releasc dctsction method at a
number of its locations.
Recently, 7-Eleven, lnc. reported suspected releases based upon SIR data tbr the previous month to this
agency (Note: Not all of thc sites Iisted may be uuder this agency's jurisdiction,).
The purpose of this fui is to intbrm thc agency as to the results of investigations and precision tank
tcsting (where required).
7-Eteven, lnc. is using this reporting format in ttre interest of efficiency beqruse of the numbcr of sitcs
that it operates.
Should you have any questious, please feel free to contact me.
vironmental Manager
Attaclunent: Investigation Details Report
Cc w/attch: Cindy Davis, 169l Ron Radle, 1897 Peggie Beta 0147 -I
Jolur Graves, I E5 I Andy Garcia, 1852
Cirypl1cc Cenrcr Ersr / 271 I Norttr Haskcll Avenuc i Dallas- TX 75204-2906 . MailinS Addrcss: Bcx 7l I / DuJlus, 'I X ?5221-O7l I
zl4lt2t.07 t I
bu-')
ffiil,
7-Eleven, Ine.
(formerly, The Southlsnd Corporation)
ENITIRONMTNTAL STRVICES DEPARTIVITNT
Corporate Olfice Cityplace Center East 271 1 N. Haskell Ave., Dalias, Texas 75204
Mailing Address: P.O. Box 7l l, Dallas, Tcxas 75221'0'1ll
PUG-18-1999 17:58 THE SOUTHL .,) CORP.
7-L ,en SIR Stores with
?14 B4t 6747 P.62/22
Non-Passing .asult 8/18/99
6130/99
Results'Mafiot# 7-Eleven #
SALT I.AKE CITY1157 CALIFORNIA AVE
SALT LAKE CITY491 EAST 33OO SOUTH
NORTH OGDEN
SALT LAKE CITY
1998 N. MAIN ST.
416 EAST 2604 NORTH
SALT I.AKE CITY
WESTVALLEY CIry
WESTVALLEY CIry2321 S. REDWOOD RD
.I395 NORTH MAIN
SALT LAKE CITY780 SOUTH 9OO WEST
TOOO SOUTH 37ZO EAST
TOOO SOUTH 3720 EAST
SALT I,AKE CITYTOOO SOUTH 3720 EAST
SALT I.AKE CITY904 EAST 39OO SOUTH
SALT LAKE CITY82OO SOUTH 48OO WEST
17 EAST MA]N ST
17 EAST MAIN ST
Storee that are Repeat Faiture will be followed up with an explanation or Pr,ecision Tank Test within 7 or
10 days untess a Preclslon Tank Test har already been done within the last 60 days.
' I = lnconclusive, F = Fail
TOTFL P.Az
AUG-18-1999 1?:58
Date: August 18. 1999
214 841 674?
rHE SOUTHLRND CORP.
\-,
Pcggie BeE,0t47
\-,
Phone (214)8ZE-5593
FAX TRANSMITTAL
2t4 e.AL 674? P.8t/A2
ENVIRONMENTAL SERVICES DEPARTMENTcorpora'le'iffi
,ft T#:;:?:;:E:I;;lL1,*:"fflll;:;r.n",1"*7s2a4
Number of Pages Including Cover page: /
To: PosITroN oN .ALL, utarrr Department of Environmentar euarityDivision "f !::r---rienrar Response and Remediation. Salt Lake cit,., utahFo<#: (g0t)S36{40r or (t0i)359-8853 phone #:(303)Gl0_aoz9
From: Ken Hillicrd, Environmental Manager
7-Elcvcn, Inc' (formerry, The southrand corporation), Daras, TexasFax #: (Zt4)g4L-6747 phone #: (zt4)B4t-65g2
Re: Reportiug of statistical rnventoryx,econcitiation (*sut,) Results for Julv lg$)*'r l*'jt'.t*!r t' ** + * **+**'tt* *rtti*!r* tit!rrtr+*++*** ** **ri* ** *i++ *+**i*J* *-*i i * +ri*++*+.,,f **r*irAur: POSITION ON CALL:
7'Eleven' Inc- (formerly, -flre southland Corporation) utilizes statistical luventory Reconciliatiou("sIR") as the release dctcction method at a number of its locations_
By way of this faced informatiorr, 7-Eleven, Inc. intends to inform the agenc,/ that t5e sites ristcd on theattachment are reportabte suspected releases based upon Sf[Jata for the prerriess monttr. Not all of thosites listed may be under this- agency's jurisdictio'. 'z-Erc.,ei.
Inc. is usi'g r.his reporting format i' theinterest of time and number of sites,i",i. op"r"i.r.' -'-'*"' '
Whcre required, precision tank tighUress tests arc being completed. Results rvill be submitted to the
;::1,"J-,Hil,iiTo'""'
7-Elevcn' Inc' is ulso inr".tila"tiil d. accounting records and equipmenr for
Should you have any questions, please feel frce to coutact me.
Attachment: SuspectedRclcaseListing
Cc dattch: Cindy Davis, 169l Ron Radle, lg97
John Graves, lg5l Andy Garcia, lg52
cityplrcc ccntcr Easr / 271r North Ilaskelr Avcnuc / I)orrrs, TxTszo4-zgo6. Mairing A<Jdrcss
2t4tE2E-07tt
Sincere
llor 7f I i Drllrs. TX75l2l-O1tl
-Eleven SIR Stores with Non-Pesarng
TNRCC
Feclllhr lD f
7-Elevan. lnc-
Addre.s Stal€
MOntn
Ending Rosult Grade
Ropoat
FailureMarket #7-Eleven|}
4000s89 1851 12932 1157 CALIFORNIA AVE SALT LAKE CITY U''I 6/30'89 RUL
4001022 t85l 211X2 5519 tvl/EST 3500 SOUTH WEST VALLEY CITY ul'5r30/99 F RUL
3000183 1 851 22099 SOOWEST I515SOUTH WOODS CROSS U'I 6/3o/g9 F PUL
4001023 1 851 ?2796 1353 INOIANA AVE SALT IJKE CITY UT 6130/99 F RUL
12AO2ZS 1 851 22E(J1 35EO S. WASHING'TON BLVO.OGOEN ul'6/30/99 F RUL
0100185 1 851 23291 10 S. MAIN ST SMITHFIELD u1'0/30,99 F RUL
3000185 I 851 23550 1998 N. MAIN ST.I.AYTON u1'6/30/99 F RUL
1 200231 1 851 2357e 2041 WEST 5600 SOUTH ROY u't'8/30/gs F RUL
1200232 1851 23842 416 EAST 2604 NORTH NORTH OGDEN u1'5/30/99 RUL
4001 026 1 851 24573 960W. NORTH TEMPLE SALT LAKE CITY ul'6/30/99 F RUL
4001027 1 851 251 16 2321 S, REDWOOD RD WEST VALLEY CITY ul'6/30/99 F MUL
.oo1027 1 g5l 251 15 2321 S. REOWOOO RD WEST VALLEY CITY U:6/30/99 F RUL
0100186 1851 25472 405 NORTH MAIN LOGAN UT 6'30/89 F RUL
4001028 1851 25587 1690 SOUTH 900WEST SALT I-AKE CITY ul'5/:t0/99 F RUL
3000186 1851 26103 1771 NORTH MAIN SUNSET u'i-6130/s9 F RUL I
3000186 1851 26103 1771 NORTH MAIN SUNSET ul'6/30
'9
F MUL
0100167 1851 2e577 1395 NORTH MAIN LOGAN u'-6130/99 RUL
4001423 1851 27075 780 SOUTH 9OO WEST SALT LAKE CITY u''l'6130199 F RUL
4001423 1651 27475 780 SOUTH 9OO WEST SALT I-AKE CITY u1'6/30/99 F MUL
40014,04 1951 29514 309 EAST 4OO SOUTH SALT LAKE CITY U;6/30/99 F RUL t
4001444 1 851 29514 309 EAST 4OO SOUTH SALT IJ\KE CITY U-:6/30/98 F MUL r
4001444 1 851 2951.1 308 EAST 4OO SOUTH SALT TJCKE CITY u-.-6/30/99 F PUL i
4000998 1 852 154ttg TOOO SOUTH 37ZO EAST SALT IJKE CITY U':6/30/99 F RUL
4000998 r852 16449 TOOO SOUTH 3720 EAST SALT I-AKE CITY U"6/30/99 F MUL
4001034 r 852 22811 6398 S, HIGHLAND SALT I-AKE CITY U"6/30/99 F RUL
4001 034 1 8S2 22811 6398 S. H|GHIIND SALT I,AKE CITY U?6r30rs9 t-MUL
90001 03 1852 23471 25OO WEST 5OO NORTH MAESER ur 6/30/99 F RUL
400t013 1 852 237a6 SO15 SOUTH 7OO EAST SANDY U':6/3ty99 F RUL
9000105 1852 238X2 1OO N VERNAL AVE VERNAL u-l 6130/99 F RUL
4000987 't852 2384,4,82OO SOUTH 48OO WEST SALT LAKE CITY u-i 6/30/99 F PUL
4001014 1852 2384E 7800 souTH 1320WEST WEST JORDAN U';6,30/99 F RUL
1 000289 1 852 23E51 1 196 WEST CENTER OREM u-i 660/99 F RUL
1 000291 1852 24299 222WEST 3OO SOUTH PROVO u'r 6130199 F RUL
9000106 1852 24443 2500 s Ht/rY 40 NAPLES UT 5R0,99 F MUL
90001 06 1 852 24443 2500 s FlwY 40 NAPLES u'r 5/30/99 F RUL
20001 38 1e52 25030 17 EAST MAIN ST DELTA u'r 6/30/99 F RUL I
2000138 1 852 25030 17 EAST MAIN ST OELTA u'r 5/30/99 F MUL
4001040 r 852 25534 1851 E MURRAY.HOLLADAY RD SALT LAKE CITY UT 6/30/99 F PUL i
4001063 1 852 25760 895 EAST 4500 SOUTH SALT I-AKE CIW UT €/30/99 F RUL
4001 018 1652 ?5791 41 10 SOUTH REDWOOD ROAD TAYLORSVILLE UT €/30/99 i-RUL
IHE SOUTHLAND CORP.
. Stores that rre Repoat Failurc will be followed up wath rn expl.natlon or Preclslon Tanli Test within 7 or l0 days unlers a
Precigion Tank Test has already been donr wlthln the lact E0 daye.
214 E41 6i4??.42/z?
7 !28tgg
TOTAL P.A2
rUL-28-1?99 1.1:57
:14 841 5?4?
THE SEUTHLEND CORP.2t4 84t 5747 P.At/22
\-\-/
ENVIRONMENTAL SERVICES DEPARTMENT
Corporate Oftice Cityaiace Center East 2711 N. Haskell Ave., Dallas, 'lcxas i5204
Mailing Addrcss: P.O. Box 7l '1. Dallas, Texas 75721-tl71l
Pltone (214)t2t-5593
FAX TRANSMTTTAL
Date: .Iulv 28. 1999
Number of Pages Iucluding Cover Page: !
To: POSITION ON CALL, Utah Depanment of Environmental Qualirl'
Division of EnvironmcntalRcsponse and Remediotion, Salt Lake Ci5', IJ16y1
Fax iI: (80t)535-4401 or (801)359-t853
From: Keu Hilliard. Environmental Manager
Phone #: (303)620-a029
7-Eleven, inc. (formerly, Thc Southland Corporation), Dallas, Texas
Fax #: [phone] Phone #: (214)8al -6592
Re: Reporting of Stetisticel Inveutory Recouciliation ("SIR") Results for Junc 1999
rt**t'a*ri+t**r:}:|*+tt*++++***f+art++*a*|l*rl**tt+**+*+{.++++++***+**i*+++*t++******+*+++*'t'
Attn: POSITION ON CALL;
7-Eleven. Inc. (formerly. The Southland Corporation) utilizes Statistica[ lnventory Reconciliation
("SlR-) ss the release detection method at a number of its locations.
By rvay of this fored information, 7-Eleven.Inc. intends to inform lhe agency that the sites listed on the
attachment are reportable suspected releases based upon SIR data for the previous month. Not all of the
sites listed may be under this agency's jurisdictiou. 7-Elevett, lnc. is usirtg this reporting fbrmat in the
intercst of time and number of sites that is oPerates.
Where required, precision tank tighrress tests are being completed. Results rvill be subntitted to the
agency when complete. 7-Eleven, Inc. is also investigating the accounting records and equipment for
possible problems.
Should you have any questions, please feel free to contact me.
Attachment: SuspectedReleaseListing
Cc w/anch: Cindy Dovis, 169l Ron Radle, lt97
John Graves. l85l Andy Carcia, 1852
Peggie Betz 0147
Crrvntrcc Ccntcr ELlt / l7l I North Hogkcll Avcnue I Dultus, 1'X 75204-2906 . Mailing Addrccq: B,rx 7l I / Dsllsr, TX 75221 -071 I
2r41828-071 r
a
.orlilio*
CORPORATION
January 28,1999
Mr. David Wilson
StAtE Of UtAh DERR
168 North 1950 West
Salt Lake city, uT 84114
RE: 7-Eleven #25030,17 East Main St., Nephi, UT
Facility ID#2000138
Dear Mr. Wilson:
Per the memo dated December 30, 1998, Southland is submitting the required documentation.
Specifi cally, attached please find:
| . Inventory Reconciliation Reports for all three tanks for the period January, 1998 through
6 k L . t;.tJ:l# forthe period September, 1998 through December, lee8 (s.I.R. was initiated
(a.p- I as a leak detection method beginning September, 1998)
, L . Copy of most recent tank and line precision tightness tests results dated I l/18/98
/(rr -)' --,A.t L/.VF ' Please feel free to contact me should you have any questions.
Department 10220 S.\7. Greenburg Road, Suite 470. Portland, Oregon 97223
Phone [phone] Fax [phone]
Bob DeNinno
The Southland Corporation
Environmental Services
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box lzl4840
Salt Lake City, Utah 841 l4-4840
(801) 5364100 Voice
[phone] Fax
(801) 5364414T.D.D.
Michael O. lravitt
Govcmor
Dianne R. Nielson, Ph.D.
ExeutiVc Dimor
Kent P. Gray
Dirtor
TO:
RE:
Date December 30, 1998
The Southland Corp.
ATTN: BOB DENINNO
PO BOX 7ll
Dallas, Texas 7 5221-07 ll
Non-compliance of underground storage tanks at 7-ELEVEN 1E52.25030,17 E.Main St., Nephi,, Utah;
Facility LD. #2000138
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and federal
UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on November 25r 1998, indicates you have not satisfied the requirements of the Act and are out of
compliance. To achieve compliance you must do the following:
Submit evidence that proper Statistical Inventory Reconciliation (SIR) is performed on USTs #1.2.
3 by documenting valid SIR test results for January through December 1998.
Please return a copy of this speed memo with the above items to speed processing. The above information must be
submitted to this office by March 21 1999. If it is not received by the date specified, we will commence the
revocation process of your Certificate of Compliance. If you have questions concerning this matter or need any
assistance, please contact David Wilson at (801) 5364100.
UTAH UST PROGRAM Facility lD No. 2 - oa. r38
Release Detection lnspection Checklist
11. l,ooation of T,mk(e){,l. Ownership of Tank{s)
Owner Name-f A. Sou*L- lo-J Co - r>
Address' -- -iltt N Hqsk e tl Aue-
City - Stale Zip Code
lJcl(a s fr TSzz t
At UST Location Phone #
Facility Name -- +'f letle""r
City ^ State Zip Code'T't+^ trT TVGz'|
Countv,Mi
Certiticate of Compliance on site?No Certificate Year: ald
lll. Tank lnformation comptere tor each bnk lt,facltliy ias morG ftan .l hnks, compleb lnlormatlon for Eddttlond..tanlra on ggp.araiQ Q*n1r
Number of tanks at lacility:
ll not in use, date lasl used
lf not in use, depth of producl in tank (in inches)
Month and year tank installed
Material of construclion of tank (steel, FRP, etc.)
Material of conslruclion of piping (sleel, FRP,
lV. HeleaSe DetACtiOn For Tankg . hdlcate ms6od(r) ured for eaoh tank CsnpF-,F.ltp.,gpproEfate q!!ecklbtror:?99-h .tt!€d.
Generator tank (leak detection deferred)
lnventory Control/Tank Tightness Testing
Statistical lnventory Reconciliation (SlR)
Other approved method (indicate name of
V. Relea.e Detection'For Piping Compleb,gpng:chacKbtinc,oppielrf$tanr.cnsaHl*{*)lorcach me6od uflf*t
Other approved method (indicate name of method)
certifythatl inspectedtheabove-namedfacility on il otl zi 79 I ()P
of Owner or Owner's Representative Present
Distribution: White-OERR, Yellow-lnspstor,
I
] UTAH UST PROGRAM
Ove.rfill. and Csrrosion Protection lns
Facility lO f.lr
ion:GheclrliotI
Ploase complete all lntormatlon for sach tank. Ue€ addiffonal torms as neoossary ll lhe faclllty ha* more than 4 taoks.
SPILUOVERFILL PREVENTISN
\Tank 1 l-ank 2 Ilrnk 3 Tank 4
The UST system is filled by transfers ol 25 gallons or less. lf yes, spill
and overfill prevention is not required.Yes @ ves @ Yes @ Yes No
ls there a spill containment bucket or another device that will prevent
release of product into the environment?
(G) No No @No Yes No
ls there an overfill prevention device installed on the tank? If yes,
indicate the type of device: Ball float (in vent line)..Automatic shutoff (in
fill pipe), Alarm, or Other (specify)
Sef No qg No \YeO No Yes No
For overrill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver? i/*Yes No Yes No Yes No Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?Yes No Yes No Yes No Yes No
CORROSION PROTECTION
Tank 1 Tank 2 Tank 3 Tank 4
lndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrilicial Anode
t""* sA Tank 5A TankSA Tank
(SA), or Not protected (NP).eioins
il/A
Pipins N pl Pipins N ful Pbins
lndicate the type ol corrosion protection on Flex connectors and/or Swing
joints: Booted (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metallic (NM) and Not
Protected (NP)
sLb-Purp6 sLuPume
B
s's-Pump
R
5r-6-Punp
DisBsr B o***J3 O*", B OispoNq
lf the UST is not protected, was the tank/piping installed before May 7,
1985? ll yes, corrosion protection is not required until Dec. 22,
1998; do not complete the remainder ol this section.
Yes rd No Yes r"* No Yes r"* No Yes r"nk No
Yes Prdry No Yes PiPE No Yes Prd@ No Yes PrdE No
The results of the last two cathodic protection tests are available (within
6 months ol installation and every 3 years thereafter).No No @No Yes No
Results of the most recent cathodic protection test.
Tank
Piping
Flex
Name o{ lester
Test
9gs'4JG ?e s 7S,y qqs tlK volts
nl ,+ volts
^1
4votts ill volts volts
rf/ rt volts . voltsilk Al * volts volts
For impressed current system: The results of the last three equipment
operation checks are available. (Equip. check required every 60 days.)7r"" No
2- Yes No 7r"" No Yes No
It the tank has been retrofit (lined or cathodically protected), indicate the
date the retrofit was completed.
Nu,ut L<r s Do A/ot 5.., Co".. "{ f, - f ]t"J i s t)/ -./ [Jr^ r r.r^.^1,)
Comments:
rnsoector'ssionature:' At^'! p Cl,J)rk nala.Alo,t z< t< lt,>
UPGRADE NOTIFICATION (Complete only for pre-1988 Tanks)
, D;a n< Ki nq understandthatthefollowingmarkeditemsmustbecompletedby
odil.*e)
)
December 22, 1998 in order to meet the 1998 upgrade requirements:tr Spill prevention for tank(s)#
! Overfill prevention for tank(s)#tr Corrosion protection for tank(s) #
o Corrosion protection for piping/flex assoc. with tank(s) # 7'r ,_ * (facility meets 199g upgrade requirements.
siqnature of owner or owne/s ReDresentative Present Durino tnsoection: l//, -r--!tX'' "^
Distribution: White-DEBR, Yellow-lnspector,Revised 5/98
Automatic Flow Reetrictor (if yee, indicde model in commonts soctionl
Automstic Shut-oft Device (if yes, indicste model in commentE sectionl I
Continuous Alarm Sygtem (if yee, indicate model in commonts
Records of last Line Leak Dstoctor performance tsst are available on-site
Dato of last Line Leak Dotector porformsnce teEt
Rosult of last Line Loak Dotector
Records of last Line Tiqhtn€sg Test are available on'site
Dat6 of last Lino Tightnoss TeBt
Reruh of last Line Tiqhtness Test
id S't'.:n6" rs <,(Utah Tester Certification Number: UT gZ
(if yes, use Vapor Monitoring checklietl
Groundwator Monitorins (if ves. use Groundwater Monitoring
lnterstitial Monitorins (if yes, use lntorstitial Monitoring checklistl
Statistical lnventory Reconciliation ISIRI (if yos, ueo SIR chocklist)
Other approvod method (if yes, use other mothod checklistl
Records of last Line Tiqhtness Tost aro available on-site
Date of last Line Tiohtness Test
Result of last Line Tightness Test
Groundwater Monitorins (if yes, use Groundwater Monitoring checklistl
lnterstitial Monitoring (if yes, use lntorstitial Monitoring checklistl
Statistical lnventory Reconciliation ISIRI (if yos, u6o SIR checklistl
Othor aDDroved method (if yes, use 6th€r mothod checklistl
Slope of piping will allow ALL product to drain into tank when suction is
released
Has only ONE check valve, located directly under pump
All above information on suction piping is VERIFIABLE. use commonts
section below to document how it is verifiable.
Signature of Owner or Owner's Representative Present During
co ^"nt", fi,al- t--. -.- 7=l-) I rt 1?" Pr* r{,lo* ;^ olt ln) 7A<
Distiibution: White-DERR, Ysllow-lnsp€ctor, Plnk-F
UTAH UST PROGRAM
Automatic Tank Gauoino
Faclllty lD No.
Manulacturer, name and modet number ot system: TZDEL Er{,tS SSOO
Please circle Yes or No for each question for each tank I lacillty has morc than 4 tanks, complete inlormation for additional tanks on
separate lorm.
3 /ffi f-i( Tank 2 (hi Tank 4
Device documeniation is available on.site (e.o.. owner's manual).d--"o (G No eA No Yes No
Records on site document that the system was properly installed and calibrated (system
and tank setuD reDort).
@No GNo GNo Yes No
System is maintained in accordance with manufacturer's instructions(records are
available on site).
@No @"o @No Yes No
The probe is located at the center of the tank. lf no, indicate tilt correction factor rrom
the tank setup report.@Nolilt:'?,oT GNoTilt: i.q
GNo
Tilt:, . Lv
Yes No
Titt:
Device can measure the heiqht o, the product to the nearest 1/8 ol an inch @No 6) Ho .6 No Yes No
Device monitors the in-tank liquid levels over the full ranoe of the tank's internal heioht (@ No Gsl No ANo Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the
device is equipped with roll of paper for results documentation)@No @ro DNo Yes No
Documentation is available demonstrating that the Automatic Tank Gauge performed a
valid leak test at least once a month ror the last 12 months
ves (fr}ves @ Yes @ Yes No
lf no, for which months was a valid test nol performed? (specify months and year, use
space below if necessary)
Seo. I " /oqJ
The tank was filled to at least the minimum level required by the manulacturer's
equipment protocol to ensure a valid leak test @No @No eNo Yes No
The tank capacity is within the upper and lower size limits required by the
manufacturer's equipment protocol to ensure a valid leak lest @*o @No GNo Yes No
Have any of the leak test reports indicated a failed test? It yes, specify in the space
below the month, year, and what follow-up actions have been taken.
Yes (fltl-Yes 661 Yes G Yes No
Documentation of perlormance claims for the automatic leak test feature is available and
shows the ability to detect leaks of 0.2 gph wilh 95"/o or greater probability ol detection
and 5% or less probabilitv ol false alarm (3rd Dartv certification).
Sro @*o (teJ ruo Yes No
lndicate month(s) of invalid or missing test:e..Le lo <,.1 -
lndicate month(s) of any lailed test:
Comments:
-H,,t< o?.:.'a7 -T<={.. in .lor., F"6JJ/y o,>.?. Tt,oT,,tLt
Lvlo
lnspector's Signature:
Signature of Owner or Owner's Representative present During
Distribution: White-DERR, Yellow-lnspector, pink-Facility/Owner Revised 12\95
Mr. William Moore
Utah - DERR
November 10, 1998
Page 2
The Southland Corporation
S.I.R. Reporting Stores
November {0, {998
7-Eleven Store #Address Catv
1851-12932qatnqq 1 157 Califomia Ave Salt Lake Citv
1 851 -19587 ?oanza 341'North Main Tooele
1851-22707?ooor<l 180 North Main Kaysville
1851-23099r{rr roes 21A2 S. State Street South Salt Lake
1851-23578tzqrzg r 2041 West 5600 South Rov
'1851-25117utastozq 287 West 3300 South Salt Lake Citv
1851-25472otcn$6 405 North Main Logan
1851-26352t2-cgzzs 1900 West 6000 South Rov
1851-2669oqmne<4100 South 6400 West West Vallev Citv
1851-26718rr<r:ro.r t 2703 South 8400 West Magna
1851-26794qqnqqo 109'South 300 East Salt Lake City
1851-26999urrra,a q 175'East 800 South Salt Lake City
'1851 -29512ua't-u >3634 West 3500 South West Vallev Citv
1852-16%5qoorq tq 10600 South 700 East Sandy
1852-22232uuttozz 5585 South 900 East Murray
'1852-229334se q-"12288 South 700 East Draper
1852-22965urnrc to 3180 West 5400 South West Valley Citv
4852-2338Vt,<qt,n<z 5900 S. State Street Murray'1852-23746r"rpro
r 3 9015 South 700 East Sq!dv'1852-23851laoozBe 12OO West Center Orem
1852-24633rooozq3 794 North State Street Orem
1852-24855ttxozqu 1620 North State Street Orem
1852-25O3Ozatz..t 17 East Main Street Delta
1852-25948ttootozo 8m2 South State Midvale
1852-26357rta,tozr 47OO South 4000 West West Vallev Citv
1852-27O28,.loro<o 6A32 South 900 East Murray
!,\-.
THE
SOUTHLAND
CORPORATION
November 10, 1998
Mr. William Moore
State of Utah DERR
168 North 1950 West
Salt Lake City, UT 84116
RE: Change in Leak Detection Method
Dear Mr. Moore:
Effective with this memo, Southland is changing the method of leak detection at
the attached referenced sites to Statistical lnventory Reconciliation (SlR).
Simmons Corporation is the vendor that Southland uses. A new tab will be
placed in the Red Compliance Manual at the site indicating this change.
Please call should you have any questions.
DeNinno
Environmental Manager
Gary Altman
Peggie Betz
Andy Garcia
Andy Poku
Environmental Services Department 10220 S.\V. Creenbttrs Road. Suite 470, Portland, Oregon 97223
Phone t50.1) 977-:713 Fax [phone]
tq
*E rt j'+ :I" T :i
i .%trft ?", i:"o4* is r'ii"r\ i}.e,l h-# q,tu;*r,\w ".".! L :i""i +"#LEA
DEPARTMENT OF E}.IVIRONME}.ITAL QUALITY
DTVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 Wast
P.O. Box 144840
Salt kte City, Utah 84ll.l-4840
[phone] Voicc
(801) 359{E53 Fax
(E0l) 536-4414 T.D.D.
Michael O. Lcaviu
Govcmor
Diaone R. Nielson, Ph.D.
Exccutivc Dirccrc
Kcnt P. Gray
Diffi
RE:
TO:
Date December 12,1997
Southland Corp.
Atfir: Bob Deninno
19033 W. Valley H*y., #D-104
Kent, WA 98032
Non-compliance of underground storage tanks at 7-Eleven, 17 E. Main, Delta, Utah;
Facility I.D. f200013E.
The Utatr Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a Certificate
of Compliance if it is determined that a facility is not in substantial compliance with all state and federal UST statutes,
rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on Decrmber 3rlgyl, indicates you have not satisfied the requirements of the Act and are out of
compliance. To achieve compliance you must do the following:
Do OI\IE of the following:
1. Submit evidence that proper Inventory Control is performed on USTs #12. & 3 by:
a. Documenting that the liquid volume in each UST is measured, each operating day, to within one-
eighth inch, including measurement before and aftcr each delivery, and reconciled to daily
withdrawals.
b. Documenting that inventory records are reconciled monthly to detcrurine the total overage.or
shortage for each UST, and the variance is compared to the allowable of 130 gallons plus one
percent of the UST's monthly throughpul
e. Documenting that the water in eaci UST is measured to within one-eighth inch, at least once per
month, and the water mealiurements (converted to gallons) are used to cor:rect the monthly
inventory reconciliations.
Submit evidence that proper Automatic Tank Gaugng (ATG) is perfomed on USTs #1.2. & 3 by:
a. Documenting that the ATG systcm performs and records a leak test at least once a month.
b. Documenting that the tqnk is fiIIed [s ths minimum level required by the manufacturer's equipment
protocol to ensure a valid tcst.
Or
,
Page2
Send leak detection records for USTs 1, 2, & 3 for tlu l*s 6 months.
please rch5n a copy of this s@ memo with the above items to s@ processing. The above information must be
submitted to this office by February l2r19ltt. If it is not reccived by the date specifred, we will commence the
revocation prccess of your Cefficate of Compliance. If you have questions concerning this matter or need any
assistance, please cotrtact Drvtd Wilson at (801) 5364100.
Phone Numbsr
Contast Peroon At UST Location Phone #
Addrese'---'-iz,t N. *.^.Lll Aa.Street Addrcsa
17 € te?qi.ai* ( it , tl\ ,!iitllr*-
County ll
Certificsto of Compliance on oite?Expirrtion drto:
that I have inspected the above-named facility on I /Z,a_ 1 1 A17 i 1., o o
Signature of Owner or Owner's Representative Present During
Distribution: White-DERR, Yellow-lnspector.
Automstic Flow Restrictor (it ves, indicate modol in commonts seciionl
Automatic Shut-off Device (if y6s, indiceto modol in commonta sectionl )
Continuous Alarm System lif yes, indicate model in commonts rection)
Records of last Lin€ Leak Detector performance t6st lre availabls on-sito
Dato of last Line Loak Dotector performance test
Resuh of last Line Leak Deteclor
Records of last Lins Tightness Tost aro available on-site
Date of last Line Tightness Test
Reeult of laet Line Tightness Teet
Name and comoanv of certifiod te6ter: / l- . , .'z -Tlta L *toc ru Utah Tester Certification Number: UT
Groundwater Monitoring (if yes, use Groundweter Monitoring checklistl
lntorsthisl Monhorins (if ves, use lntorstitial Monitorins checklietl
Statistical lnventory Reconciliation tslRl laf yes, u8e SIR checklietl
Other approved method (if yes, use othor method checklistl
Records of last Lino Tightness Test are available on-eite
Date of last Line Tiohtness Test
Result of last Line Tiohtnoss Test
(if yes, use Vapor Monitorins checklistl
Groundwater Monitorins (if yes, use Groundwator Monitorins checklist)
lntorstitial Monitorins (if yes, use lnterstitial Monitoring checklistl
Statistical lnventory Reconciliation ISIRI (if yos, us6 SIR checklistl
Other aDproved method (if yes, use bther method checklistl
Slope of piping will allow ALL product to drain into tank when suction is
releesed
Has only Ol{E check valve, located directly under
All above information on suction piping is VERIFIABLE, use comments
soction below to document how it is verifiable.
Signature of Owner or Owner's Representative Present During
/t.k )-l<rk.s rZn+s-.^t/=
Di3tribution: Whito-DERR, Yellow-ln:poctor,
UTAH UST PROGRAM FacilitytDNo.2-"goo rJF
Automatic Tank Gauging
Manufacturer, name and model number ol system: Z -{.c- i Fl,r s Sfop
Please circle Yes or No for each question for each tank I bcility has mo]e than 4 tanks, complete intormation for additional tanks on
separate torm,
Tank 1 Tank 2 Tank 3 Tank 4
Device documentation is available on-sile (e.o.. owner's manual).Yes /(D Yes rfJ Yes ffi')Yes No
Records on site document that the system was properly installed and calibrated (system
and tank setup report).@No e9 No @No Yes No
System is maintained in accordance with manufacturer's instructions(records are
available on site).d,o @*o @No Yes No
The probe is located at the center of the tank. ll no, indicate tilt correction factor lrom
the tank setup report.#n @*ollllr I a ,1
(YE) ruoYr o.ua Yes No
Titr:
Device can measure the heiqht of the product to the nearest 1/8 of an inch 6) ruo Gl tto 6) ruo Yes No
Device monitors the in-tank liquid levels over the lull ranoe of the tank's internal heioht *zD xo SA No deb No Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the
device is equipped with roll ol paper lor results documentation)@*o G9 ro @to Yes No
Documentation is available demonstrating that the Automatic Tank Gauge performed a
valid leak test at least once a month for the last 12 months 9-tt L
Yes No
tlan-
Yes No Yes No Yes No
lf no, for which months was a valid test not perlormed? (specify months and year, use
space below if necessarv) *- A-l--
The tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test 9.e<- Lt{.o-t.Yes No Yes No Yes No Yes No
The tank capacity is within the upper and lower size limits required by the
manufacturer's equipment protocol to ensure a valid leak test
j31^No @No @uo Yes No
Have any ol the leak test reports indicated a lailed test? ll yes, specify in the space
below the month, year, and what follow-up actions have been taken.
Yes @ Yes @ Yes @ Yes No
Documentation of performance claims ,or the automatic leak test feature is available and
shows the ability to detect leaks of 0.2 gph with 95% or greater probability ol detection
and 5/" or less probabilitv of false alarm (3rd Dartv certification).
Yes d,Yes @97 Yes @ Yes No
lndicate month(s) of invalid or missing test:
. S-a L_io__
tnaicatemonth(s)of anyfaitedtest: A)p C.. l_-0 J<.1 n.I-J
lnspector's
Signature ol Owner or Owner's Representative present During lnspection:
ur.Iao) r *.-^k a^J z rz^,r-J +..{.i h*i( 4:. .A- ? ^Jz i), L.j-, ,fi.*.-r 4-r,5tb
Distribution: White-DEBB, Yettow-lnspector, pink-Facitity/Owner Revised 12\95
, - urAH us.F.mftoGnaM,
Overfill. and Gorrpsion Protection ln
Faciliry tbm;
Checklist
Flc#o conpbb,dl,tnfornaton for qf,gh rank tlsc adtlftbnal lormt al n6c€$Slly f [!a,,-liil[ty has r.ner€ than /t taill€.
SPILUOVERFILL .PREVENIr,ION
Tank 1 Tank 2 Tank 3 Tank 4
The UST system is filled by lransfers of 25 gallons or less. lf yes, spill
and overfill prevention is nol required.Yes @ ves CNE)Yes @ Yes No
ls lhere a spill containment bucket or another device that will prevent
release of product into the environment?No No @No Yes No
ls there an overfill prevention device installed on the tank? lf yes, indicate
the type of device: B-g!j9C!i!.Ic!tliDe), Automatic shutoff (in fiil pipe),
Alarm, or Other (specifu)
&9 No 4:P No No Yes No
For overllll alarm only: ls the alarm located where it can be easily seen
and heard by the delivery driver?Yes No Yes No Yes No Yes No
For overlill alarm 6nly: ls the alarm clearly marked to indicate what is
meant when lhe alarm sounds?Yes No Yes No Yes No Y* No
s E:Il9F.Lg , rH(}TECT|QN
Tank 1 Tank 2 Tank 3 Tank 4
lndicate the type of corrosion prolection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (tC), Sacrificial Anode
TokSA T&k5'4 Tek5t+
Tek
I
(SA), or Not protected (NP).PpingA,lr .
Piping
AJ I,-I
PipilgNn
,n9
lndicate the type of corrosion protection on Flex connectors and/or Swing
ioints: Booted (B), Total containment (TC), Not in conlact with soil or water
Sub-Pump
A.
Sub-Punp
B."*;i:'Su Pump
(NC), Cathodically protected (CP), Non-metaflic (NM) and Not protecled
(NP)
Oispoort-Dr*snsr
/.
Dispener
/.Oi!
lf the UST is not protected, was lhe tank/piping installed before May 7,
'1985? lf yes, corrosion protection is not required until Dec. 22, 1998;
do not complete the remainder of this section.
Yes r"nk No Yes Tank No Ygs r"nk No Yes ,nk NO
Yes PiPing No Yes Pirns No Yes Pipns No Yes ,,ns No
The resulls of the lasi two cathodic protection tests are available. (within
6 months of installation and every 3 years lhereafter).@) No Yes No
Results of the most recenl cathodic protection test.
Nameof tester: ci;^l. tb[*-sf Corft-z (or?,*")3nk
' T-n co'rzo"-ktl- Pi,ing
Test oate: Lt- Z f- 5 f
Ftex
- - volts4-t4 o {.2 ^volts q.J-w'oll'volts
,7* volts volls1A y'lA volts volls
Nl,* volts , , voltst)la N ) Aott'volls
For impressed current system: The results of the last three equipment
operation checks are available. (Equip. check required every 60 days.)Yes No Yes No YeS No Yes No
It the tank has been retrofit (lined or cathodically protected), indicate the
date the relrofil was completed.
Commenls: Z-y'-r'.,.* tt'-,ttu. /acoVe4t,
lnspector's Signature: + -?- C) -J --Dare: {)-. I tiqa
U PGRADE NOTIFIC{TlQi.|-](QsCIplele only f or p re-l 988 Tan ks)
I K fi<4 L€ 3)td,*4 understand that the foilowing marked items must be compteled by
(p.inl name)
December 22, 1998 in order to meet the 1998 upgrade requirements:tr Spill prevenlion for tank(s)#
tr Overtill prevention for tank(s)#tr Corrosion protection for tank(s) #
E Corrosion protection for piping/flex assoc. with tank(s) # r d.Facility meets .1998 upgrade requirements.
signature of owner or owner's Representative present Durtnq tnsDection: tACXt L(@*^.?1l
Distribution: Whils-DERR, Yellow-lnspector,Rovissd 08/08/97
-
EPA UST-DMS, Release 2.6, Facillty Screen 1 (T-L/6)
Utah, Division of Environmantal Response & Remediation
01 Facility ID [2-000138] oz EPA ID lUTT9822s4989l03 Date Received [12-0]--951 04 Date Entered [01--15-95] 05 Clerk's Initials tcKAl
05 comments: [0]_> DENINNO FAX = 205-25L- 0809 ltl
TYPE OF NOTIFICATTON:
07 New Facility t I 08 Amended txl 09 Closure t I Actual Tanks on file {10 Number of Tanks Listed on Registration Form t 3l Removed/Closed Tanks {
I OWNERSHIP OF TAI{K(S)
11 Owner ID t 24s8)
^
3)
o1
Name: {ruu sourHLAND coRP. }Mailing Address: izzrr r. HASKELL AVE. I
)ciry {oallas fPo Box "'} srare irx} zip code {tszz1-o7r-1}County {DALLAS l Phone l(zt+) a+L-5s92l,
Change which field?
EPA UST-DMS, Release 2.6, Facility Screen 2 G-2/6)
Utah, Division of Environmantal Response & Remediation
o1- Faciliry rD t2-OOO138r {THE SOUTHLAND CORP. }
o2
03
04
07
10
II I,OCATION OF TANK(S)
Name: I7-ELEVEN ]-852-25030 lStreet Address: [0]-> t7 E. MArN sT. ItrCity [DEI-,TA ] os State tUTl 06 Zip Code 184524-
County [MILLARD ] OeL,atitude [ : : ] 0gLongitude [ : :
I-,ega1 Description t l
l
l
III TYPE OF OWNER1l-Federal t I 12 State t I13Loca1 t I L4 Commercial txl l-5Private t l
IV INDIAN LANDS
1-6 Reservation/Trust L,ands t I 17 Owned by Tribe t l
18 Tribe/Nation: [ ]
Change which field?
,\
^TAIiIK DATA
OWNER: THE SOUTHLAND CORP.
LOCATION: 7-ELEVEN 1-852-25030
FACII-,ITY ID NUMBER: 20001-38 2000L38
OWNER ID NUMBER: 2458 2458
TAI{K ID NUMBER: 1- 2
STATUS: In Use r - -, In UseAGE: ii "*'/s1 13
CAPACITY: 10,000 Gallons 10,000 Gallons
TAIIK MATERIAL: Cath. Steel STI P3 Cath. Steel STI P3
PIPE MATERIAL: FRP BOOTED STEEI-, FI,EX FRP BOOTED STEEL FLEX
PfPE TYPE: Pressure Pressure
SI]B. STORED; Gas MIDGRADE Gas REG. UNLEADED
DATE CLOSED: Not Applicable Not Applicable
HOW CLOSED: Not Applicable Not Applicable
SITE ASSESSMENT: Not Applicable Not Applicable
LEAKAGE EVIDENCE: Not Applicable Not Applicable
TANK RELEASE DET. : TTT I . C. TIDEI-, EMS-3500 TTT I . C. TIDEL EMS-3500
PIPE RELEASE DET.: ALD LTT ALD LTT
OVERFILL PROT.: Yes
SPILL PROT.: Yes
FACILITY ID NUMBER: 20001-38
OWNER ID NUMBER: 2458
TANK ID NUMBER: 3
STATUS: In UseAGE: 13CAPACITY: 10,000 Gallons
TANK MATERIAL: Cath. Steel STI P3
PIPE MATERIAL: FRP BOOTED STEEL FLEX
PIPE TYPE: Pressure
SUB. STORED: GAS PREMIUM
DATE CLOSED: Not Applicable
HOW CLOSED: Not Applicable
SITE ASSESSMENT: Not Applicable
LEAKAGE EVIDENCE: Not Applicable
TANK RELEASE DET.: TTT I.C. TIDEL EMS-3500
PIPE REIJEASE DET. : ALD LTT
OVERFILL PROT.: Yes
SPILL PROT.: Yes
Yes
Yes
. .\CATION
-ORESS:
{LVANIC CATHODIC<ROTECT]ON
INSPECT]ON hc.PORT
fr:.7.rD 3 0 [fF"s#,*r"*.
2 Comm/tment to &ce//ence'
610 Erondywinc Plory.' r wesi Chesigr, Pe' 19380
tet 610/3*7AA2- F(g, 610/34+7092
)2 E cT l4-rn
cnY, srATE -
n ,- , ,'t -
1S fore- :T!".t h
' ' 4D'f 'LL- 'te51 '7-o o f,ulool. ,t .
6ra) e
Tonk Electro Potentiols (m'
,./o
Note:
1) To mokc thc rcquirtd eleclricol contoct
with the tank for BT-1O ond STI-PS
tqnks, thc technicion i: to use o wood
or.plqstic polc with ftz wire connected
to 'o bolt tfrot mokes 'quolity' contoct
with the tsnk bottom.
2) Pteose complete this rcPort in o
lcaible mcnner.
IF ANY TANK POTENTIAL IS
CONT]NUITY TES;, CURR=NT
ON REV=RSE SIDE. ..
Potentiols Recorded
Potentials Reviewed
Voltmeter Moke/Model f,:
LESS THAN -850mv, PROCE=D
R=QUIREMINT TEST, AND SCIL
WITH
=LECTRICALRESISTIVITY TEST
by:
Dqte:
by,
Dqte:
r\n,l
r[i
q''Lno'u
-4a,i * 5.1-oo*
2ooo t3K
THE
SOUTHLAND
CORPORATION
October L, 1996
Mr. Bryan D. Whitaker
Underground Storage Tank Branch Managsl
State of Utah
Deparhnent of Environmental eualrty
Division of Environmental Response and Remediation
168 North 1950 West, 1st Floor
Salt Lake City, Utah g4116
Re:change of Release Detection For All 7-Eleven Gasoline stores in utah
Dear Mr. Whitaker:
During the past few months, this office has received a number of non-compliance letters on theunderground storage tanla at many of The Southland Corporation's ("Soithland,s,,) operating7-Eleven gasoline stores.
Most of the non-compliance issues involve the run time of the tests being conducted by theAutomatic Tank Gauge ("ATG"), and also question the percent of invlntory being used.Another related issue was the failure of the ATG to succerrfully conduct the required monthlyleak test.
It has become evident to this office that circumstances at some stores do prevent the ATG fromtesting monthly. Also, although it is believed that the third party certification allows fortesting at varied levels and run times, until these issues can be resolved, effective immediatelyit has been decided to change the method of release detection from the ATG to annual tanktesting plus inventory reconciliation for all 7-Eleven gasoline stores in Utah.
Southland will continue working with Utah to correct these perceived problems, and as soon asthey are resolved, it is Southland's intention to switch the gasoline stores in Utah back to theATG method of release detection.
The ATGs witl remain in the stores and will continue to be monitored as part of ourcompliance program. They will, however, be marked so as to alert your inspector that theyare not currently the method of release detection.
This letter should also be considered the response for any non-compliance letters receivedinvolving ATG issues, including the letters listed below from Mr. William Moore.
Oit-vplacc Ccntcr Exsr / 27ll North Heskcll Avcrru" r trr,,Ij
I[752(,.+_]9{)(r.
M;rilirrs Atltlrcss: [Jox 7ll / l)Ill:rs. .r* ,rrr,_, ,.,,
Sincerely,
The
Environmental Manager
South/Central Region
KII:cg
Bob DeNinno, Southland,
L.
October l, L996
Mr. Bryan Whitaker
Page rwo
Non-Compliance
7-Eleven Store Facility ID Inspect Date Inspector lrtter Date
#25534, Satt I-ake Ciry, UT #4001040 8116196 william Moore 8119196
{20137, Riverton, UT #4001C02 8120196 William Moore 8121196
#22567, Riverton, UT #4001005 8120196 William Moore 8122196
#22933, Draper, UT #4001009 8120196 William Moore 8128196
#23387, Murray, UT #400t037 8l2tl96 William Moore 8128196
#23850, Murray, UT #4001038 8121196 William Moore 8128196
#25948, Midvale, UT #40f1020 8l2Ll96 William Moore 8128196
#22232, Murray, UT #4001033 8122196 William Moore 8128196
f25760, Salt Lake City, UT #4001043 8122196 William Moore 8128196
#t8345, West Jordan, UT #4001001 8123196 William Moore 8129196
#22965, Taylorsville, UT #4001010 8123196 William Moore 8129196
n3844, West Jordan, UT #4000987 8123196 William Moore 8129196
#23848, West Jordan, UT #4001014 8123196 William Moore 8129196
#22967, Salt Lake City, UT #4001011 8127196 William Moore 8130196
#23746, Salt Lake City, UT #4001013 8127196 William Moore 8130196
#25946, Sandy, UT #40010t9 8127196 William Moore 8130196
#25791, Salt Lake City, UT #4001018 8129196 William Moore 8130196
#16345, Sandy, UT #40[l4l9 8129196 William Moore 913196
#27028, Murray, UT #4001050 8129196 William Moore 913196
#25117 , Salt Lake Ciry, UT #4001039 8130196 William Moore 914196
#23901, West Vatley City, UT #4001015 914196 William Moore 9112196
n6357, West Valley City, UT #400102L 914196 William Moore 9112196
#26690, West Valley City, UT #4000985 915196 William Moore 9111196
#295t2, West Valley City, UT #4001442 915196 William Moore 9112196
Should you have any questions, please don't hesitate to call me at (2L4)841-6592.
Judy Woodley, Southland, 0148
l,aura Picht, Southland, 0147
William Moore, UDERR
,QSds'-
cc:
Ron Radle, Southland, 188
,\
Michael O. l,eavitt
Govcmor
Dianne R. Nielson, Ph.D.
ExEutivc Dirctor
Kent P. Gray
Dircctor
DEPARTMENT OF E}WIRONMENTAL QUALITY
DTVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box 144840
Salt Lake City, Utah 841144840
(801) 536-41ffi Voice
(801) 359-E853 Fax
(801) 5364414 T.D.D.
RE: Non-compliance of underground storage tanks at 7-Eleven #25030. 17 East Main St.. Delta, Utah; Facility I.D.
#2000138.
The Utatr Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a Certificate
of Compliance if it is determined that a facility is not in substantial compliance with all state and federal UST statutes,
rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on January 23. 1996, indicates you have not satisfied the requirements of the Act and arc out of compliance.
To achieve compliance you must do the following:
l. Submit documentation to show that you have had a qualified cathodic protection tester test your cathodic
protection system within the last three years. The inspection report indicates the most recent cathodic protection
test was performed on lllll92.
The above information must be submitted to this office by April 15, 196. If it is not received by the date specified,
we will commence the revocation process of your Certificate of Compliance. If you have questions concerning this
matter or need any assistance, please contact me at [phone].
cc: John Wainwright, SECOR
ozmr6Ett3rn
TO: Ken Hilliard, Environmental Manager
The Southland Corporation
2711 Notth Haskell Ave.
Dallas, TX 75204
- -::._-:$;i":,an; i,.Q[1:":g-_ --
Date: February 27. 1996
From: Gary Astin
;;ilr:il;;=:-r-,--ro::
Distribution: White-DERR.Pink-Facility/Owner
[X{iiifiiiii*+li1,.,-ffi*g,r' f itii#,fi
flgi1}]fi#siii+r rii*ri#ig-iit+"fu
ffi i{H_$,P,, ffi#ltit f,mtffi#$*ffiHr'{itq+ti,.i.+li}Lriiriljjljjjiiii irirr1iiiii i'
ii: :i1: : : : :Ii :i i .. : :iiiiiriiii.-llli:liIlli$*iiiif iiiIJJi!iiil.i:i.i.:lllliiiiEiiiiitiilli
";iirrr.r ! ! ! ! ! !1 ! !1 ! ii: ! 4i4 lit litiut ltiillln! 1:iliiu.ril:i\fr G
iilillluUiiitd&t lrIirii,ffi
Tr^ll4)raak6l ro.1e)Tank 4
The UST system is filled by transfers of 25 gallons or less. lf yes, spill
and overfill prevention is not required.
Yes @ Yes 6)Yes @ Yes No
ls there a spill containment bucket or another device that will prevent
release of product into the environment?
@ No @No @ No Yes No
ls there an overfill prevention device installed on the tank? lf yes,
indicate the type of device: Ball lloat (in vent line), Automatic shutotf
(in fill pipe), Alarm, or Other (specify)
@) No @ No @ No Yes No
For overlill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Yes @ Yes @ Yes @ Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
G?No @ No @ No Yes No
f#,P*ffiffiHl-Hlffi,U*limffiH. XiiffilIil+tiilniilirlri:illlrrlliiillilflNi111s111i;ft1f:1,.;11;.11;ii11++rrX'ii1iixif
ranklil :,onulil tantli)Tank A
lndicate the type of corrosion protection: Nonconodible material (FRP)TMK
STt-04
fa*Tar*-+fenk
Composite steel (CS), lnternal lining (lL), lmpressed Current (lC),
Sacrificial Anode (SA), or Not protected (NP). lf FRP or CS do not
complete the remainder of this section.
Um
?a?
um Llm um
lf the UST is not protected, was the tanMine installed before May 7,
1985? lf yes, corrosion protection is not required until Dec. 22,
1998; do not complete the remainder of this section.
ee3 No c8 No G}No Yes No
The results of the last two cathodic protection tests are available.
(within 6 months of installation and every 3 years thereafter).
G No @No G}No Yes No
Results of the most recont cathodic protection test.
Name of tester:
TestDate: l-tl-q2
Tan*
- 11b votts
Tank
_q1b votts
Tart(
- lO lO volts
Tenk
volts
rP? velL
Llm Llm
-
volts
UM
volts
For impressed current system: The results of the last lhree/
equipment operation checks are available. (Equip. check required every
60 days.)
Yes No Yes No Yes No Yes No
lf the tank has been retrofit (lined or cathodically protected), indicate
the date the retrofit was completed.
a:i
UFGRfiD,E.;..NOffIFIG N
t ftnna,'rlaft'a- orK(o rl,*f understand that the following marked items must be compteted by
December 22, 1998 in order to meet the 1998 upgrade requirements: ! Spill prevention for tank(s)#
! Corrosion protection for tank(s) #! Overfill prevention for tank(s)#
requirements.
Distribution: White-DERR, Y Pink-Facility/Owner
Automatic Flow Ro8tractor lif ves, indicrto modal in commentr soctionl
Automatic Shut-off Device (if vos, indicrto modol in commonta
Continuoue Alarm Systom lif yec, indicate model in commontr
Records of last Line Leak Detector pertormanco test aro available on-site
Dste of lact Lino Loak Oetoctor performcnco tost
Reeuh of last Lino Leak Detector porformanco tost
Records of last Line Tiohtness Tost ar€ available on-site
Dlte of lest Line Tiohtness T6st
Recuh of lEst Lino Tiohtnoss Tost
Name and comoenv of certified teeter:Utrh To8tor Certification Number: UT
Groundwater Monitoring (if yes, use Groundwetor Monitorins checklistl
lntorstitisl Monitoring (if yes, uae lnterstitisl Monitorino checklietl
StEtistacal lnventory Reconciliation ISIRI (if yes, use SIR
Other approved method (if yes, use other mothod checklistl
Records of last Line Tiqhtness Test ars available on-site
D8te of last Line Ti
Result of last Line Tiqhtnese Test
lnterstitial Monitoring (if yes, use
Ststistacsl lnvontory Reconciliation tslRl lif y6s, use SIR checklistl
Other approvod mothod lif yee, use bther method checklist)
Operates at loss thsn stmosphoric pr€aauro
Slope of piping will allow ALL product to drain into tank when suction is
released
Has only OilE check valve, located directly under
All above information on suction piping-.rir-lrEfiffBLE, use commonta
soction bolow to docum€nt how lfiFverifiable.
lnspector'e Signature:
Signature of Owner or Ovffieprosentative Pres€nt During
Di3tribution: White-DERR, Yellow , Pink-Facility/Owner
:::::::::::I
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installedl the tank
needs to be tightness tested annually. lf the UST is upgraded the tank needs to be tested every five years. lnventory records must be kept for
each operating day.
::i::::::::::i:::ra:
lJ[#:fli
Record of last Tank Tightness Test available on-site C, No da No @No Yes No
Date of last Tank Tightness Test q -r-qs '+
Result of last Tank Tightness Test. lf fail, specify in comments section what
actions have been taken to correct the problem. Has DERR been notified?
@ Fail @ Fair @ Fair Pass Fail
Type / Brand of test equipment used:l?'eerarlfr
Name and company of tank tightness lesler: fi-y,n^lnav 11 t n Jlltl;oJ Utah Tester Certification Number: UT a?.1+
Documentation of performance claims for the Tank TightneJs'Test method is available and shows the ability to detect leaks ol
0.1 gph with 95% or greater probability of detection and 5% or less probability of false alarm (3rd party certification)
@No
lnventory volume measurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
@No @ No @No Yes No
lnventory is reconciled monthly (sum of daily over and short for each month
is compared to 1 % of tank's flow through volume + 130 gallonsl
@ No @ No @No Yes No
Which months exceed the allowable over-short? {specify month and year}
lnventory Control records are maintained and available for the past 12
months for each tank
G)No G No @No Yes No
Records include monthly water monitoring to the nearest 1/8"@ No @ No @No Yes No
Monthly water readings are used to adjust monthly inventory balances @ No @ No @No Yes No
Appropriate calibration chart is used for converting product level
measurement to gallons and is available for review
Yes @ Yes @ Yes @ Yes No
Dispenser pump has a current calibration sticker or appropriate
documentation
Gl No (a No @No Yes No
A drop tube is present and it extends to within one foot of tank bottom G No @ No @No Yes No
iiGNi
Owner/operator can explain inventory control methods and demonstrate acceptable gauging techniques G No
The volume of product in the tank is measured using a:s{jek o6ir- r$.h wt+h Gauge Stick 6Tb
lf a gauge stick is used, it is long enough to reach the bottom of the tank @ No
lf a gauge stick is used, the bottem of the gauge stick is:@ Worn
lf a gauge stick is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an
inch over the full range of the tank's internal height
@ No
lnspector's Signature:Date:
Signature of Owner or Owner's Representative Present During
Distribution: White-DERR, Yellow-lnspe[tor, Pink-Facility/Owner
::.1::::rlillll,,l,i,-1_!.itls[t#.4],.t
drHti[lffffiffi
:sin(#Kffii!w,t4
liii{i-**Ht1ll..il,
Manufacturer, name and model number of
ffi.f.IffiJ,flffi.*.lffifJ
XrjllrH
rank@ rank@ ran!@ Tank 4
Device documentation is available on-site (s.9., manufacture/s brochures, owne/s manual)@No @No @No Yes No
Rocords on sit€ document that the system was installed, calibrated, and maintained
according to the manufacture/s instructions (if no explain below)
@No GNo @No Yes No
A probe is present in the tank (checked by inspection)@No @No @No Yes No
Device can measure the height of the product to the nearest 1/8 of an inch @No @No @No Yes No
Device monitors the in-tank liquid levels over the full range of the tank's intemal height deDNo @No @No Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the device
is equipped with roll of paper for results documentation)
@No @No @No Yes No
Documentation is available demonstrating that the Automatic Tank Gauge was in leak test
mode at least once a month lor the last 12 months
@No @No @No Yes No
lf no, which months are missing? (specify months and yeao
The tank was filled to at least the minimum level required by the manufacture/s equipmenl
protocol to ensure a valid leak test t<9. - 4l ./,
@No @No @No Yes No
The tank capacity is within the upper and lower size limits required by the manufacture/s
equipment protocol to ensure a valid leak test
@No @No @No Yes No
Have any of the leak tesl reports indicated a failed test. ll fail, specify in comments section
what actions have been taken to correct the problem. Has DERR been notified?
Yes @ Yes @ Yes @ Yes No
Documentation of performance claims for the automatic leak test feature is available and
shows the ability to detect leaks of 0.2 gph with g5% or greater probability of detection and
5olo or less probability of false alarm (3rd party certification)
@No @No @No Yes No
comments: Sa-r^" alc- {l.:g* anclo*-d
lnsosctor's Sionaturg:ffiCu
Signatureofowneroro*n€isnepresentativePres€ntDuringlnspection,@a
Distribution: White-DERB, Y€llow-lnspector, Pink-Facility/Owner
1 ^\z ooo t7<
THE
SOUTHLAND
CORPORATION
March 8, 1996
Mr. Kent P. Gray, Director
Utah Department of Environmental Quality
Division of Environmental Response and Remediation
168 North 1950 West, lst Floor
salt Lake city, utah 84116
Re: Cathodic Protection Test Results
Dear Mr. Gray:
Recent compliance inspections have noted that cathodic protection (CP) test results were not
available or have failed for the below listed stores. Accordingly, attached please find the CP
tests which passed for these stores.
Facility ID #
4000999
2000138
440rc42
7-Eleven Store # Compliance Tnspector
LSs2-)*rs6 t-l 3{e,
1852-25030 %'Ca.y Astin
1,852-25424
In the future, these tests should be found in the "red" in-store compliance manual located near
the Tidel Automatic Tank Gauge (ATG).
Sincerely,
The
Hilliard
Environmental Manager
South/Central Region
KH:cg
OEA z DEffi
:,frt4ps
Ciryplace Center East ,/ 2711 Nonh Haskell Avenue / Dallas. TX 75204-2906 . Mailing Address: Box 711 / Dallas, TX 75221-0711
21+828-7011
.GALVANIC CATHODIC
^ROTECTION' INSPECTION REPORT
'rC,1TION #:J..rD 3 0
. .ORESS:
CTTY, STATE
uorrDro
pomponie,s
lh cofporoted
2 Commdment to Excellence-
610 Brond:nrinc Plorry., r Wcsi C-hetca Pe- 19380
Tet 610/3*7002- Fc 610/3p7992
'.A
I
N
d
.?
a'.4
"fr
f/;o
6rc9e
Tonk Electrolvte Potentiols
Note:
1) To makc the rcquircd electricsl eontqet
with the tank for gT-1O ond STI-P3
tonks, the teetrnieiqn is to u- q wood
or plcstie polc with f t 2 wirt connested
to i bott tirct mokri 'quolity' contast
with the tqnk bottom.
D Plcese complete this report in o- legible monner.
IF ANY TANK POTENTIAL IS
CONT]NUITY TES;, CURRENT
ON REV=RSE SIDE. . "-
Potenfiols Reeorded
Potcntials Reviewed
Voltmeter Moke/Model f,:
LESS THAN -850mv, PROCEED
REQUIREMENT TEST, AND SCIL
, ;'.1-. ;. i
4LtnT /r 7* - t
WTIH ELECTRICAL
RESISTIVITY TEST
by:
Dqtc:
blt
Dote:
;'", i',,.,:t11 .r,l:1"'^'','+i' {, i -,
;rfi i"1 <L {fir
DEPARTMENT OF ENVIRONMENTAL QUALITY
DryISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
Michael O. I-eavitt
Governor
Dianne R. Nielson, Ph.D.
Exeutive Dircctor
Kent P. Gray
Dirctor
TO:
168 North 1950 West
P.O. Box 144840
Salt t ake Ciry, Utah 841144840
[phone] Voice
[phone] Fax
(80r) 536-4414 T.D.D.
Ken Hilliard, Environmental Manager
The Southland Corporation
2711 North Haskell Ave.
Dallas, TX 75204
RECEIVED
ENVIRONMENTAL SERVICES
MAR 0t 1996
THE SOUTI'|I.AND
DALLAS
OONP()AATiUfi'
TTXAS
Date: February 27. 1996
From: Gary Astin
RE: Non-compliance of underground storage tanks at 7-Eleven #25030. 17 East Main St.- Delta, Utatr; Facility I.D.
#2000138.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a Certificate
of Compliance if it is determined that a facility is not in substantial compliance with all state and federal UST statutes,
rules and regulations.
At ttre request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on January 23. 1996, indicates you have not satisfied the requirements of the Act and are ouiof compliance.
To achieve compliance you must do the following:
1. Submit documentation to show that you have had a qualified cathodic protection tester test your cathodic
protection system within the last three years. The inspection report indicates the most recent cathodic protection
test was performed on lllll92.
The above information must be submifted to this offrce by April 15. 1996. If it is not received by the date specified,
we will commence the revocation process of your Certificate of Compliance. If you have questions conceming this
matter or need any assistance, please contact me at [phone].
cc: John Wainwright, SECOR
O2l27M*t3m
^^,l
ffii
4''lSlotu
UTAH DERR/LUST RE
Release Site No. Orl LldUk
Facility ID No. aO@138
Project Manager O-IH
Potential PST Funded Site? Vdj
.SSFSSMENT REPORT
Date Receive d l2 -l 1 9
Date Assigned
Phone:?6b-z/oo
Date Confirmed_
Spill Report/Info received Av Ahi I Tav/or
Name of reporting pany Company Name Secor
Name of RP (current o/o)
Name of Release l,ocation
Release site street address
7- Eleten tf a o3o
Type of Release: _ (piping: suctior/pressurized) _ tank (corrosion/fittings) _
FUMES:
DAMAGE:
Cty: Oe))a
spilUoverfill oump island
Age (Years) and Construction of Tank(s), Piping
Release Date(s)Confirmed? Estimated Amount
Method of Determination: _ failed TTT (vol iT w/ leak rate of gal,/hr: _ Leak Detector Alarm
-
Inventory loss (- gal);
-
failed LTT (volumetric/other) w/ leak rate of _ gaLlhr
_ Field Instrumentation (ModeUType ) w/ maximum readings of _ units
-
Permanent Closure (in-place/removal) w/
-
soil staining;
-
odors;
-sheen
on H,O; _ Analytical
_ Analytical Results; Soil (melKg) B_, T_, E_, X_, N_, TPH_, O&G_, TRPH
_ Analytical Results; Water (u_e/L) B_, T_, E_, X_, N_, TPH_, O&G_, Solvents_
Substance Released:
-
Gas (UUReg,l
-Diesel -Waste
Oil
-New
Oil _Other (specify)
Native Soil Type ; Depth to connminated soil (ft below grade)
Depth to Groundwater (GW) (ft below grade); LocaL/Regionai GW flow dir.
Slope direction of local topography ; Separation distance from soil contamination to GW (ft) _
Distance/Direction to nearest water well (tt) /-; Dist.lDir. to nearest surface water (ft) I
Dist./Dir. to nearest utility conduits (ft):
-/-Water; -/-Sewer; -/-Gas; -/-Storm
drain;
-/_ElectricDist./Dir. to nearest structure/building (ft):
-l-.;
Dist./Dir. to nearest property boundary (ft) /
Current Land Use:
-Residential;
Commercial:
-Inciustrial;
_Other (describe)
Surrounding Land Use: Residential;
-Commercial: -Industnall -Other
(describe)
Misc.: Annual precipitation (incheVyear) _; Ground Cover at Site:
RELEASE IMPACTS
_Home* _Business* _Utilities* _Outdoors _Soils _Water _Other (specify)
-Soils -
Groundwater (--ft BLS)
-Surface
Water*
-Drinking
Water*
-Utilities*_Land Surface* _Biota/Wildlife* _Free Product* _ 3rd party impacts*
Utah State Risk Manager notified of 3rd party impacts (direct/potential) on: I / by:
Agencies Notified/On-Site: LHD _DEQ/DERR _DEQ/DE _Fire Dept. _EPA _Other* fiIay indicale the need for emergency abatement action(s) & other agency involvement
INITIAL ABATEMENT/CORRECTTVE ACTION PERFORMED
Estimated volume of contaminated soil removed.4eft in-place (cubic yards or tons)
Disposal location used
Number and type of confirmation samples collected
Estimated volume of contaminated groundwater removed (gallons)
Disposal location used
Number and type of confirmation samples collected
Was the e;tent and degree of contamination defined (YesAIo)? If "No", describe future work planned at the site:
Aq+o Qcr,l dekc*ed , Pce-niu ,r1 antc or)etl +ail< - Aelpc*erJ Cr,i lu ro
Atnch site map showing depths, locations & results of all environmental samples collected as well as other relevant info,
+)
)-. (/-
{z*-
fr. oro^ -. , ,/ , ,r,',4/
o,-/,-,7_6< -
i't 9z-^
Ttca
/ ,-4 ,/ /-
^
SECOR
I n te r t t ctt itt t ta I I r t co$tcnut ed
December 1,1995
Mr. Kent Gray
Division of Environmental Response and Remediation
Department of Environmental Quality
168 North 1950 West - lst Floor
Salt Lake City, UT 84116
Re: Suspected Tank Failure Reporting at 7-Eleven Store No. 25030
17 East Main Street, Delta, Utah; Facility ID 2000138
SECOR Project No. T0999-192-41
Dear Mr. Gray:
On behalf of The Southland Corporation, this letter is formal notification that a suspected tank tightness test
failure was recorded at 7-Eleven Store No. 25030,located at 17 East Main Street, Delta Utah. This condition
was originally reported by phone to the Department of Environmental Quality (DEQ), Division of
Environmental Response and Remediation on December l, 1995 at approximately 3:15 pm by SECOR
International Incorporated (SECOR).
The premium unleaded gasoline tank automatic tank gaugrng system has recorded failures on subsequent
tightness tests. A precision tightness test has been scheduled for the morning of December 5 1995. SECOR
will notify the DEQ of the results of that test.
Please feel fiBe to contact me if you have any questions regarding this site or the release, by calling the ,SECOR
office at 801 -266-7 I 00.
Sincerely,
S E C O R I ntcnutional I nc orp o raledfu-tM
4anetS. Roemmel, CPG
Project Manager
cc: Ken Hilliard, The Southland Corporation
John P. Wainwright, SECOR
23842rct
4001 Soutb 700 Eust, Stritc 250. Sctlt lcrke Citv. ttT I'i4107-2178 (801 ) )66-71(x) (tiol ) )b6--t iti I:L\
DERR
EI'IVIRONMENTAL RESPONSE & REMEDIATIOIJ I
^^
StrCOR
Intern ctt ion ct I I n co tpo ratcel
January 9,1996
Mr. Doug Hansen
Department of Environmental Quatity
Division of Environmental Response and Remediation
168 North 1950 West - lst floor
.salt Lake city, LIT 84116
Re: Results of Precision Tightrress Test at 7-Eleven Store No. 250i0
17 E. Main Street, Delta, Utah
Release Site 02I4JGK; Facility ID 2000138
Dear Mr. Hansen:
As a follow up to the reported suspected release at the above-referenced 7-Eleven store, the results of the
subsequent tightrress tests are attached to this letter. The precision test was conducted on December 5, 1995
by Tanknology Corporation Intemational (Tanknology) on the premium unleaded tank system in response to
successive failed tightness tests run with the Tidel automatic tank gauging (ATfi) system, 'Ianknology
conducted tests on the tank, lines, and leak detectors. The tank and lines tested tight and the leak detector
passed the test.
Sincerely,
S E C O R I nte rnalio nal I nc orp orated
Roemmel, CPG
Attachment
John P. Wainwright, SECOR
400lSoutb700llcrst,stite250.sdltl.ukeCity.Lil tJ4107-217u [phone] ftJ)t)266-711tit:tt,\
DEC-15-1995 L4.t4 A IHE SOUIHLITND CURP.
l.'T{N KN OLOG y COR POBATION TNTER NATTO NAL: '. . 9226 |bllrtd. Hd,rre\ trs ,?O.$EaO. prFa O6t |!r{d8 f^I Or 3t 8gOz25S
Certificate of Tightness
gcllct, OrrJer #: 16183f: Test Dale: LA/OS/93
nd storage tank system(s) tested and found tlght for:
SOUTHLAND CORP,
250eo
7-l t 17 E, I'IAIN
DELTA, UT Aqe24
r Line(s) only,1 Leak Detector(s) only.
lLt) Ei4 L b(q( f.0t/94
1
067 GERALD EGGLESTON 05/96
UT-Of32 GERALD EGBLESTON' 0E./27
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JRN-45-1996 tzt4tso* lbl 73b THE SOUTHLRND CORP.
Owner: 9-ou4/ ahe(2t4 B4t 6?4? P,A3/43sltc* SosO
When OWNEB or tocat regulatlons requlre tmmedlate reports of system fallure-Comptete the followlngr
REPORTED
TO:
or.RegdabryAgenc,y
Fero
tl
Eqq laToa O(rf / uT- ott
cen'edreslBrs"o-9
"//
DaeTestng Comflebdn Dec /.f
TOTRL P.A3
^
Personai Communication
Documentadon Form
DERR Fax #: [phone]
Dar-' Su rLt'EL
Time: 1"0o signurur", 'l^rr.f^ #o'* -
Facility ,r' 9ooot78 Spttt to: €SCrk
Contact's y1un"t 5".$DOero-,cl Company Name: 96CoL b ?-t( fvlL
Telephone No.:2a6 _?10o
05/3L/95 14:05 FAI 80t-\ss sts3 DIY Er.iv RESP REI{*- liEsIE9E FUEL ECU
\UST lnstallation/l.Jpgrade Notit, \;n
I Ncw lnsra[ruon I x I Upgradc
TankOwnar The Sguthland Corporation
16 ooz
The Urah Undcrground Storage Tank (UST) rules (Utah Administrative Code F1311-Zo3-3) reqirtra thar UST lnsalles notify
the Erecutive Secptary, Utah Solid and Hazardous Wasta Control Boerd, 3O drys belore insultlng ar upgrading rny' regutated UST systcm. This lorm has bagn prepared to sssist you ln providing rhis lrrformatloru Betom lttEEllng or
'\ r Flamediation at the address bclow. lt eny tanks or lines ara tenloyrd or replacsd, I Closun Plen lor horc trnls or llnes
must be submitled rnd approved, and a site assessmcnt must be pedormed at closurc.
zc)(x)t3g
Faclllty lD* (ll not a new fasility) 25030
D,t6wortwlllcommencr JulY, 1995
5.
Phons*( 3031 740-9333
Address 7167 South Alton Way CIV r"gf.rooa $atc-.,!O Zp-1Qsl!-
Cotrtac{ Prrson ln cherge ol
Feeility Nama,7-11 Store
Addrcgs 17 East Main citu Delta sErte rx Zp3!524 '_
Phonet(801 ) 864-4017
known at this tiue.' . To'be notified .,.
soon as contractor is selected Ceil f TL Erp- dste-
Phone * (
s.ata zo-
Contast pctsoq
I
Not
Certifird Tank lnarallgr Name as
Company
Address
ln*allati on/U pgrade lnlormation
Tank +r
lnstalUupgrade
Gapacity (gallons)
Type (FRP. Steel. eta)
Substancc to be stored
:.Piplng Typ.e (Press., Suclion. Gravity)
Tank Leak DetEction mcthod
Line leEk ddeaion mathod
. Form of Conosion Protection
Spill device to be lrrsndled (YN)
I
Uoerade'
10 .000
-
Uperade
10 ,000
Upgrade
10,000
Gasoline
Press.
ATG
Gasoline
Press.
ATG
Gasoline
''Press.
. ..ATG
A
A Over{illdevice to be installed (Y/N) y
Unusual or ertcnurtlng circumrtanccs arpected:To install flex connectors at
I
Y
MPDts and S.T.P. rs
AL RESPONSI & R,:^
Mall completed lorm to:lJta]r Department of Environmcntal Ouality
Division of Errvironrnental Besponea rnd Remsdbtion
168 North 1950 Wesr. lst Fler
Salttaks Clty, Utrh 84116
Bcdd By- Noticr 6rntTo O/O 'Hh r,lDEsEt3 ule Onltr Detr Rsc'd
,orlHio,u,
May 15, 1995 coRPoRArloN
Mr. William Moore
State of Utah
Department of Environmental Quality
Division of Environmental Response and Remediation
168 North 1950 West, lst Floor
Salt Lake City, Utah 84116
Re: Change of Contact
Dear Mr. Moore,
This will confirm my phone conversation with you in which you were notified that I am the contact
for The Southland Corporation (Southland) for all environmental issues in the State of Utah.
J'v6$
Effective immediately, please address all correspondence to the following:
1
Mr. Ken Hilliard
Environmental Manager
The Southland Corporation
2711 North Haskell Avenue
Dallas, Texas 75204
Phone # [phone]
Fax # (214)84t-6727
As an additional item, if possible, could a copy of all correspondence be addressed to Southland's
environmental consultant at the following address:
Mr. John Wainwright Phone # [phone]
Senior Project Manager Fax # [phone]
SECOR International, Inc.
4001 South 700 East, Suite 250
Salt Lake City, Utah 84107-2t78
Please disseminate to all appropriate DERR personnel. Your assistance is greatly appreciated.
)
fincerely, ,/'/ rszfutfruLAND coRPoRATIoN
- --/.', / ' ,%.' tKen Ffiuiard
/ / Environmental Manager )
Central Region
cc: Gary Davies, Southland Bob Vasquez, Southland
Bud Good, Southland John Wainwright, SECOR
(.rrrr.i.r.t. (.(rrr(r [:.,\r / ]-tl \,rrrlr Fl.r.kcll .{rcntrc / I).rll.s, f},*,1i1-,',, ,,,. \l.rrlrn,: .\.i.ir
RONMENTAL RESFONSE & REiViEDIATiCI I
Oistribution: White-DERR, Yellow-lnspector, Pink-Facitity/Owner
Distribution: White-DERR, yellow-lnspector, pink-Facility/Owner
{*rrtiiiri#l ffi. ir,iiiiilij jr#ii
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installed) the tank needs
to be tightness tested annually. ll the UST is upgraded the tank needs to be test€d every five years. lnventory records must be kept for each operating
day.
ilii:l::'i:i:ii:iiiiiiiiii:i:iili::ii'ii::iriiii;iiri;ii:li.i:lilillllii:ill.',1:iiilll::il::::r.1.iriiir.;:r.r.irriijjj::j:ji riii,i
iliiiiiiiinliiiiiiiitiiiixilt$#Nl$,!!illffiltlli.Til8sffi liuE$m l$Fj
iiiiili;i;li;;Ji ::iiii;iiiiiliiiiiiiiiiiiiiiii
iiiiiil,ffi,r,F,#iiiiiiiililir
Record ol last Tank Tightness Test available on-site Yes @ Yas @ Yes @ Yes No
Date of last Tank Tightness Test .* - 2f' 1 I ? -lr1-Q*
Result of last Tank Tightness Test. lf fail, specify in comments section what
actions have beon taken to correct the problem. Has DERR been notified?
@ Fait @ Fait @ Fair Pass Fail
Tank Tishtness Tssting method: A U-lo"no* ic- Ti-nk- Ga-r-tetina
Name and company of tank tightnoss toster: sEr6r2 , n':;1i;::1 f^-V7.-;yyr^nrester Certification Number: UT ot ,tZ
Documentation of performance claims for the Tank Tightness Test method is available and shows the ability to detect leaks of 0.1 gph
with 95o/o or greater probability of detection and 5% or less probability of false alarm (3rd party certification)
(9 No
iiiiiiii:'siiiirliiiL!l:iliiir
iii*?r,-qLliir-iiiij ',',,,l:,::i
jll.il,l RX:tr;j:ri;;li
lnventory volume measurements lor regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
@ No @ No CO No Yes No
lnventory is reconciled monthly (sum of daily overages and shortages for each
month is less than 1olo of tank's flow through volume + 130 gallons)
@ No 6 No @No Yes No
ll no, which months were not? (specify month and year)
lnventory Control records are maintained and available for the past 12 months
for each tank Ca;7y.rnettl [.re-lorrt
@ No @ No @No Yes No
Records include monthly water monitoring to the nearest 1/8'@No @ No flA No Yes No
Monthly water readings are used to adjust monthly inventory balances @ No @ No @No Yes No
Appropriate calibration chart is used lor converting product level measurement to
gallons and is available lor review
@No @ No @No Yes No
Dispenser pump has a current calibration sticker or appropriate documentation @3 No @ No @No Yes No
The drop tube in the fill pipe extends to within one loot of tank bottom fO No @ts No (5) No Yes No
Owner/operator can explain inventory control methods and figures recorded @ No
Books appear used and evidence of recent entdes is apparent @ No
Owner can demonstrate acceptable gauging techniques @ No
The gauge stick is long enough to reach the bottom of the tank @ No
The ends of the gauge stick are flat and not worn down @ No
The gauge stick is marked legibly and the product level can be determined to the nearest 1/8 ol an inch over the full
range of the tank's internal height
@ No
*[xiiiFixiii*ffi ;iiiiin:$fi i*ffi
co ^"*", Reeoda ore llepl al SLC OfiL-
lnspector's Signature:Dats: / ^ /a'qq
Signature of owner or owner's Representativo Present During tnspect ion //'l
'- o-l -
Distribution: White-DERR, Yellow-lnspeclor, Pink-Facility/Owner
Manufacturer, name and model number ol
Tank 1 Tank 2 Tank 3 Tank 4
Device documentation is available on-site (e.9., manufacfure/s brochures, owne/s manual)F6! No (oNo @No Yes No
Records on site document that the system was installed, calibrated, and maintained
according to the menufacturE/s instructions (if no explain below)
@No @No 6No Yes No
A probe is pr€sent in the tank (checked by inspection)@No @No @No Yes No
Device can measure the height of the product to the nearest 'll8 of an inch @No @No @No Yes No
Device monitors the in-tank llquid levels over Ure full range of the tanks intemal height (3No @No @No Yes No
A monitoring box is present and there is evidence that the device is working (i.e., the device
is equipped with roll of paper for results documentation)
@No @) No @No Yes No
Documentation is available demonstrating that the Automatic Tank Gauge was in leak test
mode at least once a month lor the last 12 months
@No @No @No Yes No
lf no, which months are missing? (specify months and year)
The tank was filled to at least ihe minimum level required by the manufacfure/s equipment
protocol to onsurs a valid leak test tSl/'- q, %
@No @No 6No Yes No
The tank capacity is within the upper and lower size limits required by the manufacturo/s
equipment protocol to ensure a valid leak test
@No @No @No Yes No
Have any of the leak test reports indicated a failed test. lf fail, specify in comments section
what actions have been trakon to corroct the problem. Has DERR been notified?
Yes @ Yes @ Yes @ Yes No
Documentaiion ol performance claims for the automatic leak test feafure is available and
shows the ability to detect leaks ol 0.2 gph with 95% or greater probability of detection and
5% or less probability ol false alarm (3rd party certificatlon)
@No @No @No Yes No
Comments:
lnspecto/s Signature:
signature ol owner or owner's Representiative presenr During lnspecti o, ,/r/ 4t .-.-,:r4d4k-
Oistribution: White-DERR, Yellow-lnspector, Pink-Facility/Own€r
,HBI"ll*hi,tN,##.;fl.I,,1iii$s$Eiii'I#
iill;iiiiriil,::iiiiiiiiii;lilili!i!!,!llirl1ii1r.;i:iiiririiiir:]llliIir:Iirrl
,SHIIUOVEHIfllsEi]$rilg,rT+trlffi-$El-Tg r
Tank'l Tenk )Tqnk a Tank I
The UST system is filled by transfers of no more than 25 gallons at one
time. lf yes, spill and overfill prevention is not required.
Yes (9 Yes @ Yes @ Yes No
ls there a spill containment bucket or another device that will prevent
release of product into the environment?@@ @@ &@ Yes No
An overfill prevention device is installed on the tank. lf yes, indicate
the type of device in the space below.
@ No G)No @ No Yes No
Ball float valve (in vent line)
Automatic Shutoff valve lin {ill ninal I rd-(\t t-1 \u a-(
Overfill Alarm \zO3 va-q va<
Qther Svstem (soecifu tvoe)
For overlill alarm only: ls th€ alarm located where it can be easily
seen and heard by the detivery driver? ivt Sidc_ a-tarwr
Yes @ Yes G]Yes @ Yes No
For overlill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?@ No @ No @ No Yes No
frtt$iffiiijiffi[1#
Tlnk I Tank )Tank 3 Tank 4
Tanks and/or lines are made ol a noncorrodible material (such as
fiberglass) or are made of steel clad with a noncorrodible material. ll
yes, cathodic protection is not required.
Td(b No
fu*
@ No
Ter*
@ No
Td*
Yes No
Um
G}No
Lim
@ No
Llm
€&No
Um
Yes No
Tanks and/or lines are made of unprotected bare steel and were
installed prior to May 7, 1985. lf yes, cathodic protection is required
on or by December 22, 1998.
Tar*
Yes (od
Ta.*
Yes @ Yes 6b
Tmk
Yes No
Yes @ Yes @
Llm
Yes @
Ure
Yes No
lndicate type of cathodic protection: lmpressed Current (lC) or
Sacrificial Anode (SA)Satti€.,ilA^,J..
The results ol the last two cathodic protection tests are available.
(Tests are required within six months of installation and every three
years thereafter). 36/,0p
Yes @ Yes (0 Yes @ Yes No
Results (in volts) of most recent cathodic protection test.
Name of person who performed test: f.EClL) Acc+q$u_Tt
testoate: Ji.noo;tvll,l442
,r,' q1L votts
Tar*
- 1 9L vofts
Tar*
- lOlO votts
Td
volts
FR.? volts
UM
volts
UM
volts
um
volts
For impressed current system: The results of the last three
equipment operation checks are availablo. (Equip. check required every
Yes No Yes No Yes No Yes No
lnspector's u/-L L
Signature of Owner or Owner's Representative present During
Distribution: White-DERR, yellow-tnspector, pink-Facility/Owner
CUSTOMER: SOUTHLAND CORP (7-11) SITE lD: 25030
ADDRESS: 3146 GOLD CAMP DRIVE ADDRESS: 17 E MAIN
CITY:RANCHO CORDOVA CITY: DELTA 1nn^/?x
STATE: CA ZIP: 95670 STATE: UT ZIP: o-v vvt JU
Testinq Evaluation Report
The USTest 2000 System declares a tarrk to be leaking when the measured leak rate exceeds
the threshold of .05 gallons per hour and lras a probabilily of false alarm of <1% and a
probabilily of detection of >99%.
TANK 1 TANK 2 TANK 3
SYSTEM
INFORMATION
VOLUME VOLUME VOLUME
DIAMETER DIAMETER DIAMETER
FUEL TYPE REG UNLD FUEL TYPE PLS UNLD FUEL TYPE SUP UNLD
TANK TYPE TANK TYPE TANK TYPE
FUEL LEVEL FUEL LEVEL FUEL LEVEL
WATER IN WATER IN WATER IN
WATER OUT WATER OUT WATER OUT
SYSTEM
RESULTS
LEVEL t LEVEL t LEVEI-,,I
ULLAGE ULLAGE *I
,. LEAK,,,
,
DETECTOR
PASS
N/A
LEAK
DETECTOR
PASS
N/A
:: :ILEAKI :I:]:::: : ]
,,iDETECT6R,.','.,
PASSiNA
LINE ,PASS/.OOO LINE PASS/.OOO ,:LINE:' ,' 'i',PASS/.000
VAPOR II N/A VAPOR II N/A VAFOR ll ,,,,
TANK 4 TANK 5 TANK 6
SYSTEM
INFORMATION
VOLUME VOLUME VOLUME
DIAMETER DIAMETER DIAMETER
FUEL TYPE FUEL TYPE FUEL TYPE
TANK TYPE TANK TYPE TANK TYPE
FUEL LEVEL FUEL LEVEL FUEL LEVEL
WATER IN WATER IN WATER IN
WATER OUT WATER OUT WATER OUT
SYSTEM
RESULTS
LEVEL LEVEL LEVEL :
ULLAGE ULLAGE ULLAGE
LEAK
oEtecToR
LEAK
DETECTOR
,, lffi(,, :,,
:DETECtOR,:
LINE LINE ,L]NE
VAPOR 1I VAPOR II VAPOR II
ATG functional: YES tr NO O
' Produr:l line and rnechanical line leak rleteclor tesls orrly.
TECHNICIAN: DALE slMMoNS cERTrFrcATtoN #: _u$TjE_q_6 _DATE:sgp-tqnt_Uerl4;!_xg4
0
L0o/t9g
Leak Detection lnspection Checklist
l. Ownership of Tank(s)ll. Location of Tank(s) ,
Owncr Namo (Corportdon, lncllvldu.l. Publlc Ag.ncyr o. oor.?.ntlty):
''',o-4h la^ ,[ (o. tr 'r', J- u .',
Stra.t Addr!3t----diZ'F No,*t^ t)asLi "q{-^ un;+ bz{
Counry
Clty.,n - Stat, Zgcorl,o
WrlJz r- , (aa/a.a cta ZO zr L
Cont cl Porton At UST
er eppllceblo
Numb.r ol T.nkt .t Thll locadon:
Frclllty lDr, Z- O oo l3 g
Pbase complm ail nbnna[on to7 each anl( It t1l3 le&ry hes mor! t .ta r 4 trnl(t.Ill. Tank lnformation rEo! qIfrEE o. Erlqrr5gr rq E*.r E.^. rr urr. ,snry.,o..Ms sE. ! 8..
olesse onffioov fiir oaoe and comol€te fie nbrmaton tor all acldtttonsl l8nkg.
Tank oresenrly in uso
lf not. dat6 last us€d
lt €mpti€d. venfy 1' or l6ss of produci in tank
Month ano Year Tank lnstall€d (E-€srimate or K-knot,w|l
Matenal of Consndion (E-€$imate or K-knotflnl
Caoacrt-v ot Tank (in sallons) (E-6rimal6 or K-knownl
Subslance Stored (E-€$amate or K-known)
lV. A. FleleaSe DeteCtiOn FOf TankS Checrt thc relero cletrctqr m€OroCI(s) used lbr c6.rr tBnk or N/A t nqtc rrquqo.
Manr.alTank Ciar.rging (mly fortanks under 1.00(, gat.)
Manr.ralTank @ugirq and Tank Tightls T€slit|g
(only lortanks underamo gBl.)
Tank Tiglnness T6lng and lnverilory comrol
Other aoproved mefiod (lrrite in name ol mdtod)
lV. B. Release DeteCtiOn For Piping ch€d( th. rtlcer da6on rrdroct(s) rJ..d lc prptng . t
Ch€ck Ono Type o( Piplng lor each Tarik
Automatic Line l,-Eak Detectors, and
lV. C. Corrosion and Spill/Overfill Protection
Conosion protection inslallod (indicate date)
Spill/Ovarfill protoction anstall€d (incticirto datel
V. Site lnformation ,-!.-.1
G€neralsdeobservationsendcommens(vrcin,tyobsefvations'goundwabr wra.*-l A)o ,,ir) /^k zz. f?fotkrt
t (z-u ()- Unnslc-that I ha,e impoccd tr. abore named laciliV on m' f nh=l%kl{o c--
SJs
I
3.f
C.\
I
\o
srG$r
\l)\
Facrlrty lD #:
PfeSSUfiZgd Piping A morrloct must be 6al€ctad from Eh slt Wh€re appflcable indlcata dab o, lsst test It this relrty h8 nro'lulsn 4
tanks, pleasD photocopy thrs F*?e 8nd cornpm t1e infurmeton lor all adclitional otping.
Set 1 Tank 1 Tank 2 Tank 3 Tsnk 4
Automattc Flow Restrictor
Auomaltc Shutdf Devic€{),,4Z il"o- tl zi r il-- rt q?
Contrnuours Alarm System
and
Set 2
Annual Une Tighfi€ss Te$ing f)- rt o'?/=. tt.q<,O:.' it 4 ?
Vamr Monilonng
lf Vapor MonitorinE, docJmontation of mornnry
monttonng ts available
lrner$rtial Monitonng
ll lrterst[ial Monitorirp. documemailon oil momhly
monitonng is available
Ground-Watr Mmitoring
lf Ground-Wat€r Monnoring. doatrnerilalion of monhly
rnc,nttoring is availabte
Olher Approved Mdlod (sp*ify in comments ssdionl
Suction Pioinq', tndtclb dsb ot rnoct rant b.t
Une fighhacs TdlnE (r€quirBd 6y€ry 3 y6ars.f
Vaoor Mmitfring
S€condary @ntainrnent wat1 lnterstitial Monitonng
Ground-Wat€r Monitorino
Other Aoororred Mdlod (sp€crfy in comm€nts sedionl
No Leak oetecilon Rcqulrcd
(must annver yc! to lll of thr followlng questlons)
Op€rates at lcs fian almclspfiaric pr€ssurE
Has only one cfieck valye. whidl is locatec, dirsctly
under pump
Slope of piping allorvs product to drain back iilo tank
wh€n suctim r€laas€cl
All abov€ information on suction ptparE is venfiable
On th6 back of U1is shest. please sk€tch the site. notlng all piping runs. tanks (lnctucting siz8 & sub$ances stord)
and localion of wells and their distance from tanks and piping.
comments: '1^' ,,,", fz.-L.-*r.,l -',1^lnr'.s ,,/t n^ ':--n. '.J /('l-
ln J<"i-or, ,..,'/,'- zi^nr ur{ ,'--.'..- ,^ ''..o/) ),1<. l.- ,.-. il5 o'
in :) sr"''St"s. ,Ne y't^oller^< r"z, ,-le l,
lnspeclor's Signatrc:
srde-5
rrl \-,
t
*-bvu^
2ttl-,rt.
ACI1
qr
FacdityrD* z-east (t-itar"n" f []-l
Mand&trer. narneandnrode{number ,or*rr,, 7' ,\e I 1nn 5" 3;oo' E?l{u{r" l'k*?:{er',-ti
Please answer yes or no for each question
Devtco documentation is available at s[6 (e.9.. mandacturer's brochur€s. own€rs manuatl,yqi rcl r<
Devics can measure hoighl o, produa lo nearGt onHighth of an inch.y€s I ')4 not
oocumenataon shou6 that water in bonom ot tank is ch€ck€ct monthly to n€ar6t one-€ighrt
ot an inch.
Y€s I .+/-rnl
Device will declare a leak on the basis of inverlory r€conciliation if discr€pancy €xce€ds 1%
or rlow-through, plr.s 130 gallorE on a monthly basis.
yes I '"rtrl
DoqJmontation is available that t16 ATG was in lest mode a minimum ol once a monh.y€61 >no
Ch€cked for presence of gauge in tanks.YesL.'<--nol
Ch€ck€d for prG€nca of monitoring box and €vicrence that clevica is workng
(i.e.. devi6 is equipped with roll of paper br results docurnontatim).
Y6l*nol
Owner/operabr has clocum€ntation ori file v€rifying m€6od meets minimum F,€rformancs$andards d .20 gph with probability of der€dion ot 950,6 and probability ot false alarm ot 5o/o
for automatic tank gauging (9.9.. results she€ts und€r EPA's 'Stanclard T€st Procsdur€s ror
Evaluating l-eak Det€ction Metlrcls').
Y€s [-i=nol
Ch€d(ed croqJrn€ntatlon i1at system was irstalled. calibrat€d. and maintain€d accoroing to
rnanuf acilJrers irsfirtiors.
y€s t I1oI F
Maintenance r@rds are available upon r€quest.y6[nol x-
Monitoring and tGtlng reccds are available forfi€ pasl 12 rnonfis. 2,,,2 )- - )n--s y€s no
ft-e ys*er, { a\''^l
u/?"* )4'
€)*. i'if,)5(p+ ' '
/r s /', i,,,,,,'.1{, :g.
^ I / s e-1 /-/.."-r^[ //nt€
,AF-
,,,Ju u,)s l J.:
Cornments:
,/ae *ez-L,ru as ,7pr --),fi.) /4 Z, f , n'l-/)t-;/"4/1 Q *hl ,,,L\ *i-i,-7(ez-c45. /*^/C!'
art< .i-r<^A- L*' -iirarT ,!- t'L<cl, /-- .r^L.- *)f'1^ z lza*1--.,i ,ls/-'rl.-.
/-t
lnsp€sbr'ssignatre:4t q -gi Dab:
srGo-a
1
FACILITY ID.
PST PROCESSING CHECKLIST
2acuzx
Year q I
Non-Marketer Discount
NotUnacceptable Acceptable Applicablr
,-/
Previous
LUST
Form
Pollution
File
fncluded
Inci-dence
vtNz
dAJ
TTT
- Verify tank/Iinesvs registered
- Documentation ok?
- Rate ok?
VlY/N
Y/N
Y/N
Fund Paid
.FY9L Y/N ,r/*)ttz
Fees Paid
FY 88?
FY 89?
FY 90?
FY 9 ]-?
-/v
,y
Compliance
Compliance Outstanding?
- Leak detection required?
- Notification up to ciate &
_ Application?
complete ?
Date eualified
Review completed and certj.ficate issued
suPPoRT \CE \CHECKLI ST. PST
by
2000138
PETROLEUM STORAGE TANK FUND APPLICATION
FACILITY INFORMATION:LOCATION OF TANKS:
Owner Name: 7-ELEVEN sALES coRpoRATr0N FacilityName: 7-ELEVEN 25030
City
Cou
City: nettaCounty: JuabState: ,T^H
unty: snlr uxu
rte:State:- u
Street Address-: +27 LAwNDALE DRrvE
SALT LAKE CITY
84115
Street Address: rZ Easr iiain
Phone:
Contact
rr rul rE. (8011262_6484
UOntaCt PerSOn: JoHN p. cHtRBy
Phone:
TYPE OF OWNER:
[x ] Marketer, or non-marketer with annual monthly throughput greater than 10,000 gallons.
[ ] Non-marketer with annual monthly throughput less than'10,0b0 gallons (Must veiify).
DESCRIPTION OF UNDERGROUND STORAGE TANKS:
lge res4 1eB4 - reE-uapacrry 10 . 000 10 .000 10 .000 +Aft{t_ ISF__Substance
TANK TIGHTNESS TEST U?4H DEPT. OF HEALTHPFAI I nf FAllrlErJnr'.!{a::a,Y
r3!_5r ##
CERTIFICATE OF REGiSTRATION
h. I All Underground Storage Tanks (UST) at this facility have been registered.
W OU registration TANK Fees have been'paid.
COMPLIANCE WITH UST REGULATIONS:
is tle applicant currently in compliance with all Federal, State, and Local UST regulations
I x ] Yes t I No -- lf "No" please describe item(s) of non-compliance:
PREVIOUS POLLUTION INCIDENT(S)
|ayq .you gvg_r had a pollution incident at your facility?[ ] Yes -- lf "Yes" please provide LUST (L-eaking Uniderground Storage Tank) lnformation:
[* ] No - !f "No" please attach a letter stating that under customary business inventory
practice standards you are not aware of any release fiom any tank(s) at this facility.
PST FUND FEES
t ] Full payment for every tank at this facility is included with this application.
[x ] Quarterly payment(s) for every tank at this facility are includeO witn this application.
I certify under penalty of law that the above representations made by me are true and correct.
Applicant's signature :Date signed:
W ':z
PETROLEUM STORAGE TANK FUND CHECKLTST.
1. CERTIFICATE OF REGISTRATION:
fifl All Underground Slorage Tanks (USTs) have been registered - Form 7530 (Revised 9-89).
S Registration Tank Fees have been paid - 1988/1989 = $2SAank/yr, 1990/1E91 : $4S/tank/yr
2, COMPLIANCE WITH UST REGULATIONS:
I I Tanks inetalled before 1965 or unknown: release detection by Dec. 1989.
[ ] Tanks instslled '196$'1988: releas€ detection to be completed by my compliance date.
[ ] Release detection completed upon installation.
ffi t am in compliance with all other Federal, State, and Local UST regulations.
PST FUND FEES .. ANNUAL FACTLITY MONTHLY THROUGHPUT:
I an q marketer, or I am a non-marketer with annual facility monthly throughput greaterq 10,000 gallons.
I I SZSO payment/tank: Fiscal year (July t, 1990 - June 30, 199i).
t I Quarterly payments @ $62.50/tank (Due the tst day ot Jut, Oct, Jan, and Apr).
I I I 3m a non-marketer with annual legI-E qonthly throughput tess than 1O,OOO gallons.
[ ] I have completed the APPLtcATlomR NoN:MARKETECs DtsCouNT forr;-
I I $125 payment/tank: Fiscat year (July 1, 1990 - June 30, 1991).
I t Quarterly payments @ $3l.25ltank (Due the lst day ot Jul, Oct, Jan, and Apr).
4. TANK & LINE TIGHTNESS TEST - ACTIONS REQUIRED AFTER TEST:
4(nt systems pass the tank and tine tightness test$'fi1 am submitting the results of the taiX tightness test and a copy of the fietd report
[ ] A,lltanks do not J'f.eet^the rgq_qleqents set by rule regarding tank tightness testing.
[ ] I have contacted the State UST office and will submitividenlce of a-pran for revievV.
5. PREVIOUS POLLUTION INCIDENTS:
ffihave completed the PREVIOUS POLLUTION INCIDENTS forM
'y\tt customary business inventory practice standards, I am aware of any release from the
tank.
6., INDEPENDENT FINANCIAL ASSURANCE records at
I have obtained financial responsibility requirements for the first g25,0OO/release:
b/sr,r tnsurance
'( |nirr retention group
I I Guarantee
I I Letter of Credit
I I Commercial lnsurance I I Surety Bond
I I CIher:
I have obtained independent third-party financial assurance by my compliance date.
I will obtain independent third-party finincial assurance by my compliarice date.
rsee explanati)ns under "Hot r do I get started?"
FTEUTI IJI #2000138
PREVIOUS POLLUTION INCIDENTS
To:Mr. Deruris Downs
Executive Secretary
Utah Solid & Hazardous Wastes Committee
Dear Mr. Downs:
As required by paragraph 26-14e4O4 of the Underground Storage Tank Act, I have
performed a tank and line tightness test on each underground storage tank at my facility,
and based on this test, there has not been a release of petroleum. Additionally, based
on "customary business inventory practices standards", I am not aware of any release of
petroleum from my tanks.
qR,
I have had the following releases of petroleum (detailed below; also mention any action
you took to clean up the release).
signature of owner/operator
Failure to repoft Previous releases could void.'rour coverage under the Petroleum Storage
Tank Fund.
-98 UrED 16:12 SOIJTHLtrlHD 1,IKTG \P - 82
:
;'l I t
S.I B II. tTY
rhe Southland Corporation hereby certlftes bhat lt i.s inco'rtolianee wtbh bhe requi, rements of Sut-rpar! H of 40 CFR part ZgO.
The f inanc i'aL as.Eurance meehanism usei to demonstrate f tnaneialre$oonsi.blli.ty under Subpart H of 40 eFp part 2BO ls as tlollowg:
T r revocabre standbv [,etter of cr:eri it \o. ez sdg, t ssurrd byNCNB Texas Natlona't- Sankr on Jantrary 24, 1gg9 t r)t)rsuant to40 CFR 280.99r EQ .lemonstrabe Einanciat - responsihtti tv foci.akinq -correebiue aeLlon aacl/or compensatinq thirri par|.i;;!or bodity lnjury and property aamaqe ciuse,.l rrv. i""i;;;;;ireleases 1n t.he amount oE a't 'i.east $i, f, O'O',000. 00
-t';;;
oecurrence and fi2r000,000.00 annual aqgreoaEe.
THF: SOT'THI.A}.ID CORPORATTON
lv:
rlame:
'ri ttefnaEes U.e'eh 16-. lq8;-- -
9'NATE Of,' TEXAS
COI'NTY OP NATLAS
s
s
s
hruiiiA C. i:i: j.:l;:,'i-i), li i''rrr Pu':li0
i6 3;1d li:i' [:i"; r,;.I;rltiilU.f
My Cm:rnisii'rn E;:;,;r';3 L
-.\r .:uBggRIBED AND sr,rORN ro BEFoRE MF: rhts Mray of//"LJkdg-, 1989. --t ^ /)
ltv Com,n t ti ton Expt res !
:'
BFSGR3I :
TAr{r$oLoqy coRpoRAnoN TNTERNATIO}{AL
5225 Hollister, Houston, Texas llO4OA294
Certificate of Trghmess
Phone: (713) 690-TANK
Scrvice 0163r * 13 3 71 .
Fax: [phone]
TrltdrE L2/L4/90
[ ] PipirB only.
Ouan-
unltgtqr5 rEat l*ffiD E rd hrn t1trk
[;"Jrank(s) & PlpirB,I I Tank(s) OnV,
Ouan-
Tank owner/Address southland 7t67 s. Alton way Enslewood, co
Test SIE Address
Tank sizes & products EsEd
Tank #1 lOK RITN, Tank tt? t OK nnr:- rank tt? 1nr errr\,
8011 2
PipirB Tested Lines: 1A ,2A,3A.
reg Robbins
#64 5/10-/q?Gdbtrt_!'eflmm v (artr SU. S. P.t.nt . #224, Crn dlm P.t.nt . il05695, Eurog.D prt nt ApCl:. f 6*IANKNotGY & Vacufcct rc tradcmrk! of T^llt(tlq.06y CCnpmfftOt NftillfnOul
VCEonlywih
CoOaeSal
ttE Sss YurTd Td nft E ffi ltr{lbatin rd * bc&r fi*tgr
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Location Diagram -1 -t\1 1t-.L
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rcguletioar orCivncrlleffiiiffiffiF]Reported to:
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6ood
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,, l:-j,.'l q!
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tt?d,
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Customer 5o '.t-r+t-6ill r+ L fo 3 o
LINE TEST LOG 1337)
I z- -l'l - qD
s.o.#
Date
KNOLOG
rccH(orooY Fon r^fir5
^t o ?xttF €xvttolir€xr
Ts-uk No./--Line No.z*Product ? t- ii
ll
ilPipine Material - s@- Test Pressure 50 psi Calib.Multiplier ,1P:12-
rfl rt r61 ba;zq V;f <&o'1 Z
it __:
iluNAr LiNE tIGHrxEss RF.TE: d - , FAIL I I
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il
,ao>n<1
iicoupnrssioNlZ.rrEar.L""-a- --- -- Tert Pr"sJ;;Pres.Level _-i 7. IilLrJeil
iiTEST ii I.EVELA Voluue AreA ii
--il _.__-__ LINE TEsT ___il
ri-llil{is-ns-lis-;i: Lg"s!-*JsystA-r-}&l}ed+Epis$-{--9.f.il-A --ii,i yo;o:- istart llr.i i*ffiEl fiffinnm4; ffi ii..-.--rl
il/?'' lu - !.- -;!!:. -/- ' - ,4--;- *-*:32--..-,-c-t 73': ---- -:i
j[ l"t {zi 4 iJi,-:U__i_J__i .or1Il]-_.1_.
ii,o-f -5 lil* I::rurffiil i6l ii'__l
||FINALLINETIGHTNESS RATE: _ fl -, FAIL t I or pASS X Ill a
;i Comments: ,ll'.ffi...---='.'..'".ffi-- :-:ffiffi:-:l+l-.n:Erz:-jffi:-'ffi=:ffi:,::==::lJFORI{ No.: LincTcrtt,og. t/t9
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, FAlt" I L;;--E-ssffi,i
iTaak No.
il Line No.Product
iiPipiag Material
;l
Test Pres.sure __ psi Calib.Multiplier
Ffffi:T=i:=::=:::=::':==::::=:=::::==-..=.: j:::=;--=:=:-
ii lgry Rr s s r o Ni;-z ;;F;.;til;i - Test Pr;.-i;".ITESTLEVELAVolume A
LINE TEST
ir--.
i LevelA, V;Ir,_ql$_Ei;cted ffii_
il
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'lCom-ents:
Technician _ oou4
TIGHTNESS RA,[E:_,FAJLl
VecqTcst ccnirJ
Ior PASS I
No.; LinaTatLot. l/69t.
DEC_
TAI.IKNOLOGY CORPORA
5225 HolllStgr, Hougton, Toxas 77040-6294 Phoner (713)
rtifiCile of Tlghme$S scrytca ordgr * ., 13 3
Un*grurd *rqgE E* syens} hfid fid hnd lgltloc
[ 6nl Tank(s) & Pipitu,I I Tank(s) Only,
ouan.
Tank Owner/Address Sout,hl?+d 7167,,j?. A1ron.,l{?v Endler{.ood, cO
8011 2
Test Slte Address Soulhrand #25Q30 17 E. -Main st., ne tta. ur ne42
Tank slzee & produots teshd
Plplng Testeo Llnes: 1A,2A,3A.
reg Robblns#64 5/to/q2
riffitrffi,,%i
XIE.C_TE-98 TIJE
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looation Diagram
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--ai:iffi _El=!*iJg3lBE:--,::Efi :E-r
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rFft.-illi'..'.'.'.-4*kft+'n.-%_--Ek.Bs.
ry.{-+-q.-,,.++k r-*tufr.kh,-
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to:
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Nrso
ooo./
Vrcntcct(tn) CartLflcrtlol Nrnbor
-*-Lr-:!--*-Drtc Trrriu6 complctcd ForruTerrDrh t/f,g
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LINE TEST LOG S.O.# lg37)
Cu*tomer 9ovr,'n{++a.lrt,,Tf:.jlf%ll--h. -=*ffi Date Jg-:jl:-'A
_*----LLq*_-4tE__g-r_,}.-egifl *_ur__e,.J3J_**G.*
Ta.nk No. -,-.--,-j: _ *Llue No,"-A Product R t*
llPining Material -5ffi1L* Test Pressure
-e--
psi Calib.Multiplior .fg:I_?_-
il co r,fpRFs B itJfiIffi-Eo:Ei ;;i :H:" _:_a* t TEffi
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itIt0 {L-
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---'Piping Material -#,: - Test hersure -P-- psi Calih.Multiplter :,r"gi3-
l#"j*+:*s-+1iiE::ij-:3::=E:-r:l!i-$1rif*i:..=".---ri.; ?':-,j':';r,ti? aii!itr.-ts,E*:1t:E€3Eii=li-c=ffi!:fi:uE5H'Eti5.---.]Ej.,!r.-?==;il-
rl
lll'ank No.[,ine No.Product
I
...ri tiatrrxt F. 64
-E*ricFi+,{
Pi'ping Marerial
CTIfiFRESsid
TEST
Zero Pres,L.eyel
I.RVNLA Test Pres.teyei
Volume A
Te*t Pressure *.-- psi Calib.lHultiplier
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I I l-. Dalaaaa Flalaa*ian lnan^alian I
I vv i I rsrEclr)g ygtglrllvl I r: lr)lrgvtr\r! I i
4lt8l20Lt
Tanks
IG- lAil -
['*-Fil-
fNrA F,il -
fY"' lAa-
Tanks
lY*- Fil
*
rc- lAr -
lG- fil *
lNf- hil -
l-Y"' lAil
*
Fil*
Comments
Tanks
lG- lAil
*
lc- Fii--
Corrosion Protection
Tanks are protected from corrosion?
Flex connectors at the tank subpumps are
protected from corrosion?
Containment sumps are sealed, free from
water, product, etc?
The results of the last two cathodic
protection tests are available (within six
months of installation and every three
years thereafter)?
; Follow Up on Corrosion Protection
Spill/Overfill Detail:
Tanks have a Spill Prevention device or
are exempt from this requirement?
Are you able to visually inspect the spill
containment bucket(s) for functionality?
(i.e. are the buckets clean enough to see
cracks, etc?)
Is the spill containment bucket(s) intact?
If the spill containment bucket(s) is not
intact, does it have a potential to release
product to the environment?
r Follow Up on Spilfoverfill
Piping LD Detail:
Do all of the pressurized piping systems
have a line leak detector?
Do all of the pressurized piping systems
have a valid annual line tightness test or
valid monthly monitoring?
Piping is U.S. suction?
The database has been verified and
updated?
Follow Up on Piping Leak Detection
Financial Responsibility
The database has been verified and
updated?
Financial Responsibilty Method is ok?
Follow Up on Financial Responsibility
Piping is protected from corrosion?
Flex connectors at the dispensers are
protected from corrosion?
Impressed current system is checked for
proper operation at least every 60 days
and the results of the last three checks are
available?
Have you updated the database with the
current Cathodic Protection test?
The database has been verified and
updated?
Is the spill containment bucket(s) able to
contain a spill? (i.e. is there water,
product, debris, etc in the spill bucket to
prevent it from containing a spill?)
Tanks have an overfill device or are exempt
from this requirement?
If an overfill alarm is being used is it
properly located so the delivery driver can
hear or see it and is clearly identified?
The database has been verified and
updated?
Do all of the pressurized piping systems
have a valid annual line leak detector test?
If using monthly monitoring, have you
entered the results in the table below?
U.S. suction piping has a valid line
tightness test every 3 years?
Ownership of Tanks
Name l7-ELEVEN tNC
DALLAS rW
arc.Westfall@7-1 1.com
Inspection Date:
Detail:
Detail:
lc;-
l%:-
INA lAil -
Tanks
lY.*;-
V
Tanks
l^il
Piping qualifies as Safe Suction. (Documentation is available and verifiable to show that piping operates at less than
atmospheric pressure, has only one check valve (under pump), and has proper slope of piping. If all these criteria
are met, no leak detection is required on the piping.)
Inspector:
Record Created by:
Time Record Created:
lnspection Date:
i LD substanlial:
i Op"t Substantial:
I
Contact IMARC
Phone l(702) 270-7123
Facility ID #: 2000138
Location of Tanks
7-ELEVEN 1852-25030
17 E MAIN ST
43s) 864-4017
IG- fil -
lffi*-l\il*
Tanks
l€r-* fiii--
f*- fiil-*
f- lAil
*
f-hil-
SEANWARNER
swarner
411812011 3:22.52 PM
4118t2011
irl
i,L
Page 1 of 5
Facility ID #: 2000138 Inspection\.,t 4lt9lzDLl-
lTank LD-ATG/IM Detai! :
i
lATG/IM - Leak Detection Method Used?
I
itfU - fype of Secondary Containment Used?
I
IIM - Type of Documentation Used?
IIM - System is capable of detecting a release of regulated substances from
lany portion of the primary tank/piping within one month of release?
I
IATGiIM - Records on site document that the system is properly installed,
lcalibrated, operated, and maintained (system and tank setup reports,
I maintenance records)? Written documentation of calibration, maintenance,
land repair is kept for at least one year after work is completed?
I
I
]ATG/IM - ATG console or other eguipment used to take readings and perform
]tests is adequate, accessible, and operational?
I
llfCTtm - Documentation of valid testing or monitoring is available for the last
j12 months? Show results in table below.
I
I
IATG - The probe is located at the center of the tank? If not in the center,
yshow tilt factcirs from the setup report.
I
llfC - fn" tank was filled to at least the minimum level required to ensure a
lvalid leak test, and the tank size is within the allowed upper and lower size
llimits?
The database has been verified and updated?
i_fJ Fdbw y_p gl Enk leak detection
I
Fi--F,-
lAil
*
f,, -
FaE;,T-
IN/A|iltr'-
lil'/A-
l%;-
lc;- Fii-*
lc;-
IV;-{-
Page 2 of 5
Facilitf ID #: 2000138
, I Mo7yr, oqltql, o5/to
t z
Inspection oate 1o/r illzott
o6lro ozro- oslro 0e/10 10110 11l10ii 12110 0u11 02lti',, 03111
Tank#.1 P PiP P P P P P P P P P P P P P.P P P P P P P P
I Show results of monitoring for the last 12 months. Pass(p), Fail(f), Inconclusive(i) or No results(nr).
(Tank Results in first bo:t, line results in second)
Show resutts of monitoring for the last 12 months. Pass(p), Fail(O, Inconclusive(i) or No results(nr).
(Tank Results in first box, line results in second)
Mo/yrl$@|=bilio 06/101 0z1ili_ bb7io,; 0e/i0 ioliollrm.-uii:i orirr oztr7, osni,
pjrii prp;, p:pr, elelii;e,,e p p itiP;ili p,p'p P P p,ltiii
Show results of monitoring for the last 12 months. Pass(p), Fail(f), Inconclusive(i) or No results(nr).
(Tank Results in first box, line results in second)
Page 3 ol 5
Facility ID #: 2OOO138
lTank Status:
lR Vendor
TG Vendor/Model
Vol./Max. Cap.:
Monthly Thruput:
Release Detection:
ALDTffype/Passed?
LTT/Method/ Passed?
: Yes Other
. Vol./Max. Cap.:
Monthly Thruput:
Pipe Belease Deteclion:
Date LTT/Method/ Passed?
PSTFund: Yes Other
Inspection\-z: 4lLal2}lrl
i E-Gerr: l.io
Currently ln Use Manifold: No
v
lDate lnstalled/Capacity/Loc: 4/1611984 10,000 West
I
jTank Material: Galvanic cathodic Prolection (STIP3)
lTank Modifications: None
Line CP TesVPassed?
ank Release Detection:
TTT/Method/Passed?:
No Other
E-Gen: No
ank Status:
Date lnstalled/Capacity/Loc :
Tank Material:
ank Modilications
Pipe Material:
Modilications:
Pipe Flex Connectors:
Type:
Stored:
Description
ank C P MeULast TesUPassed? YES 12i16i2009 Yes
Line CP TesVPassed?:
ank Release Deteclion:ATG
USTMAN SIR
Veeder Root
'10% old 57o new
227,559 glmo
1. LTT
1i10i241 1
TTT/Method/Passed?:
Vendor
TG Vendor/Model
ALDT/Type/Passed?
1,10i201 1 Tanknology
ATG
USTMAN SIR
Veeder Root
'10% old 57" new
227,559 glmo
1. LTT
1,10,'2011
1110t2011
No
No
TLS.3sO CSLD N
45K
ALD
Yes
Yes
Tanknology
ALD
Yes
Yes
Currently ln Use Manifold: No
4116/1984 10,000 Center
Galvanic Calhodic Proteclion (STlP3)
None
Fiberglass Beinlorced Plaslic
None
Booted Steel Flex'
Pressurize Perm RD by:12/2211998
Gasoline Regular
5 gal. Spill Bucke Automatic shutoff
/Vo
TLS-350 CSLD N
45K
Page 4 ol 5
^!hcility ID #:2000138 ^Inspection l
I
lTank Status:
I Date tnstattedlCapacity/Loc :
lTank Material:
iTank Modifications:
lPipe Material:
Modifications:
Flex Connectors:
Type:
Substance Stored:
Spill/Overf ill Descriplion
Tank C P MeVLast TesVPassed?
Line CP TesVPassed?:
Tank Release Detection:
TTT/Method/Passed?:
Vendor
TG Vendor/Model
Vol./Max. Cap.:
. Monthly Thruput:
Release Detection:
ALDT/Type/Passed?
LTT/Methodl Passed?
TFund: Yes Other:
Cunently ln Use Manifold: No
4l'1611984 10.000 East
Galvanic Cathodic Proteclion (STlP3)
None
Fiberglass Reinlorced Plastic
None
Booled Steel Flex
Pressurize Perm RD by:1212211998
Gasoline Premium
5 gal. Spill Bucke Automatic shutoff
YES 12i16i2009 Yes
ATG
iVo
USTMAN SIR
Veeder Root TLS-350 CSLD N
10% old 57" new 45K
227,559 g/mo
1. LTT 2. ALD
1i1A2U 1 Yes
1l 10i201 1 Tanknology Yes
No OtherType:
I
i
I
I
l
1
I
I
Page 5 of 5
,*545r ..AL
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