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Home My WebLink AboutDERR-2024-005104 WESTECH EQUIPMENT 195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307 801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX 801-261-4054 SPILL BUCKET INTEGRITY TESTING HYDROSTATIC TEST METHOD SINGLE- AND DOUBLE-WALLED VACUUM TEST METHOD Facility Name: Smith’s #94 Owner: Smith’s Food and Drug Centers, Inc. Address: 479 South 600 East Address: P.O. Box 305103 City, State, Zip: Salt Lake City, Utah 84102 City, State, Zip: Nashville, Tennessee 37230 Facility I.D.#: 4002468 Phone #: 801-977-2012 Testing Company: Westech Phone #: 801-266-2545 Date: 2/7/24 This procedure is to test the leak integrity of single- and double-walled spill buckets. See PEI/RP1200 Section 6.2 for hydrostatic test method, Section 6.3 for single-walled vacuum test method and Section 6.4 for double-walled vacuum test method. Tank Number 1 1 Product Stored RUL RUL Spill Bucket Capacity 5-Gallon 5-Gallon Manufacturer OPW OPW Construction ☒Double-walled ☐Single-walled ☒Double-walled ☐Single-walled ☐Double-walled ☐Single-walled ☐Double-walled ☐Single-walled Test Type ☒Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☒Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☐Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled ☐Hydrostatic ☐Vacuum ☐Double-walled ☐Single-walled Spill Bucket Type ☒Product ☐Vapor ☐Product ☒Vapor ☐Product ☐Vapor ☐Product ☐Vapor Liquid and debris remove from spill bucket?* ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No Visual Inspection (no cracks, loose parts or separation of the bucket from the fill pipe.) ☒Yes ☐No ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No Tank Riser cap included in test? ☒Yes ☐No ☐NA ☒Yes ☐No ☐NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA Drain valve included in test? ☐Yes ☐No ☒NA ☐Yes ☐No ☒NA ☐Yes ☐No ☐NA ☐Yes ☐No ☐NA Starting Level 12” 12 1/16” Test Start Time 1:56 1:56 Ending Level 12” 12 1/16” Test End Time 2:56 2:56 Test Period 1 Hour 1 Hour Level Change 0” 0” Pass/fail criteria: Must pass visual inspection. Hydrostatic: Water level drop of less than 1/8 inch; Vacuum single-walled only: Maintain at least 26 inches water column; Vacuum double-walled: maintain at least 12 inches water column. Test Results ☒Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Buckets tested were newly replaced. *All liquids and debris must be disposed of properly Tester’s Name Sean Jardine, UT-0397 Tester’s Signature WESTECH EQUIPMENT 195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307 801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX 801-261-4054 UST OVERFILL EQUIPMENT INSPECTION AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE Facility Name: Smith’s #94 Owner: Smith’s Food and Drug Centers, Inc. Address: 479 South 600 East Address: P.O. Box 305103 City, State, Zip: Salt Lake City, Utah 84102 City, State, Zip: Nashville, Tennessee 37230 Facility I.D.#: 4002468 Phone #: 801-977-2012 Testing Company: Westech Phone #: 801-266-2545 Date: 2/7/24 This data sheet is for inspecting automatic shutoff devices and ball float valve. See PEI/RP1200 Section 7 for inspection procedures. Product Grade RUL Tank Number 1 Tank Volume, gallons 19,782 Tank Diameter, inches 118 3/8 Overfill Prevention Device Brand OPW Type ☒ Automatic Shutoff Device☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve ☐ Automatic Shutoff Device ☐ Ball Float Valve AUTOMATIC SHUTOFF DEVICE INSPECTION 1. Drop tube removed from tank? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 2. Drop tube and float mechanisms free of debris? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 3. Float moves freely without binding and poppet moves into flow path? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Bypass valve in the drop tube open and free of blockage (if present)? ☒Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present ☐Yes ☐No ☐Not Present 5. Flapper adjusted to shut off flow at 95% capacity? * ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No A "No" to any item in Lines 1-5 indicates a test failure. BALL FLOAT VALVE INSPECTION** 1. Tank top fitting vapor-tight and leak free? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 2. Ball float cage free of debris? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 3. Ball free of holes and cracks and moves freely in cage? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Vent hole in pipe open and near top of tank? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. Ball float pipe proper length to restrict flow to 90% capacity? *** ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No A "No" to any item in Lines 1-5 indicates a test failure. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Automatic shutoff device tested was newly replaced. *Use manufacturer’s suggested procedure for determining if automatic shutoff device will shut off flow at 95% capacity. **If a ball float valve is found to fail the inspection, another method of overfill must be used. ***Use manufacturer’s suggested procedure for determining if flow restriction device will restrict flow at 90% capacity. Tester’s Name Sean Jardine, UT-0397 Tester’s Signature Overfill Prevention Equipment Inspection OPW 61 and 71 Series Overfill Prevention Device Inspection (Non Testable) Customer Name: Facility ID #: Address: Street Date: City, State Tank Designation 1 Part 1 - Proper Height Setting Calculation YES NO PASS FAIL OPW Installation Manual H15524PA Rev L 1/30/2014) Maximum Tank Volume (Gallons) Shown on customers provided tank chart Gallons 19,782 Max Shut off requirement for flapper is 95% %95% Multiply maximum tank volume by 95% (Gallons)95%Gallons 18,793 Find the dip stick number on the tank chart that corresponds with 95%X Inches 106.250'' Measure top of fill riser threads, or face seal adapter A Inches 55.250'' Find the Dip Stick Volume that corresponds with 100% (FROM TANK CHART)Y Inches 118.375'' Upper Tube in tank (Y) -(X) = (Z)Z Inches 12.125'' Subtract 2 inches from upper tube in tank Formula: (Z) - 2" = (C )C Inches 10.125'' Calculated minimum upper tube length Formula: (C ) + (A) = Upper Tube Length Calculated Inches 65.375'' Actual measured upper tube length (without fill adapter)Actual Inches 65.875'' Part 2 - Device Certification Citeria Evaluation Criteria 1 Does the overfill prevention device meet the 95% requirement?YES (If Actual is greater than or equal to calculated ( YES) (If Actual is less than or equal to calculated ( NO) Criteria 2 Is the actual measured upper tube length 6.5 inches or more than the fill riser?YES (C must be 6.5" if not then the upper tube length is 6.5 plus measurement A) (For testable models ending in "T" upper tube length is (C)+ (A) - 1 -1/2". If less than 6.5" than it is 6.5" +(A) - 1-1/2") Criteria 3 Does the overfill prevention device function function as required?YES (Inspect the device for damage, contamination, freedom of movement, weakening due to wear and corrosion) Part 3 - Device Certification PASS / FAIL PASS Technician certifies that the device is operationally compliant. If the response to Criteria 1, 2, and 3 above are YES. Date: OPW 71SO-410C Overfill Drop Tube Make and Model Tank Chart Comments: 2/7/2024 Signature of Technician: Tank Chart Provided by Xerxes Smith's 94 4002468 479 South 600 East Salt Lake City, Utah 84102 Xerxes 2/7/2024