DERR-2024-005169

APPLIED ENVIRONMENTAL SERVICES, L.C.
PO BOX 1073 BOUNTIFUL, UTAH 84011 801-540-9258
TEI 5000 NON VOLUMETRIC, TEI 4000 VOLUMETRIC, TEI ULLAGE, TEI LT3
PRECISION TANK & LINE TEST RESULTS SUMMARY
INVOICE ADDRESS:TANK LOCATION: WORK ORDER #
TECH # 94027
TECHNICIAN: SM
STATE TECH #
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
IRON COUNTY ROAD
1105 NORTH BULLDOG ROAD
CEDAR CITY, UTAH 84721
24023
UT 0121
DATE:
3-7-2024
TIME START:
10:00
TIME END:
15:00
GROUNDWATER DEPTH:
N/A DW TK
TANK TANK
CAPACITY
11996
PRODUCT
DSL
TANK
PASS
VENT
PASS
PRODUCT
LINE
PASS
LINE LEAK
DETECTOR
PASS
WATER IN
TANK
0.0"
PUMP
TYPE
PRESS
TANK
MATERIAL
DWF1.
2.
3.
4.
5.
6.
PRODUCT LINES TESTED AT 50 PSI FOR 15 MIN
LINE RATES (GPH)
1.
2.
3.
5.
6.
DSL -.010
ADDITIONAL INFORMATION:
CERTIFIED TECHNICIAN SIGNATURE:DATE:3-7-2024
These systems meet all requirements set forth by USEPA 40 CFR and has received third party certification.
4.
TEST METHODS USED FOR THIS LOCATION
TEI 5000 NON VOLUMETRIC TANK TEST TEI 4000 VOLUMETRIC TANK TEST TEI TANK ULLAGE TEST TEI LT3 LINE TESTXX X
LINE LEAK DETECTOR TYPE & SIMULATED LEAK RATE
1.
2.
3.
M = MECHANICAL E = ELECTRONIC # = (GPH) RATE
4.
5.
6.
M 3
All tests were performed according to manufacturer protocol, and within the common practices of the industry. However due to the variables of
tightness testing, these results cannot be guaranteed. There are no warranties expressed, written or implied.
DEQ ID#6000090
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.03.15 11:22:35 -07'00'
Reason: I am the author of this document
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UT 84141-1152
[phone]
GAS STATION INSPECTION REPORT
Facility ID#
Facility Name and Site Address: Date:
Purpose:Regular______Reinspection_____Complaints______Annual Inspection ______
Nu
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Pumps tested for calibration
Water tests/Fuel storage
Storage tanks properly labeled
Fill caps and underground storage covers-good
Fuel filters on pumps
Overfill prevention valve
Security seals intact
MOTOR FUEL PRODUCTS USED FOR INSPECTION
Regular_____ gallons Unleaded Regular_____ gallons Unleaded Plus_____ gallons
Unleaded Premium_____ gallons Diesel_____ gallons
Product was returned to fuel storage tanks.
Inspection Remarks:
Received by:Inspected by:Steven B. Martin UT0121
Applied Environmental Services L.C.
ACTION TAKEN
IRON COUNTY ROAD DEPARTMENT
1105 NORTH BULLDOG ROAD
CEDAR CITY, UTAH
3-7-2024
6000090
X
1-2 X X
XX
X
X
X
X
12
Dispenser Continuity Test X
IRON COUNTY ROAD DEPARTMENT
1105 NORTH BULLDOG ROAD
CEDAR CITY, UTAH
6000090
STATE FUEL NETWORK
APPLIED ENVIRONMENTAL SERVICES
PO BOX 141152
SALT LAKE CITY, UT
BRETT GURNEY 385-602-4872
801-540-9258 3-7-2024
1
DSL
VAPORL
2000
X
33
32
100
2
19
2
X
X
X
X
STEVEN B MARTIN
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.03.15 12:01:57 -07'00'
Reason: I am the author of this document
IRON COUNTY ROAD DEPARTMENT
1105 NORTH BULLDOG ROAD
CEDAR CITY, UTAH
6000090
APPLIED ENVIRONMENTAL SERVICES
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
BRETT GURNEY 385-602-4872
801-540-9258 3-7-2024
DISP SU
DSL
X
X
X
X
X
X
X
X
STP SUM
DSL
X
X
X
X
X
X
X
X
TK INTER
DSL
X
X
X
X
X
X
X
X
STEVEN B MARTIN
APPLIED ENVIRONMENTAL SERVICES, L.C. PO BOX 1073 BOUNTIFUL, UTAH 84011
801-540-9258 [e-mail]
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.03.15 11:59:38 -07'00'
Reason: I am the author of this document
AUTOMATIC TANK GAUGE OPERATION INSPECTION
Facility Name:
Address:
City, State, Zip Code:
Facility I.D. #
Testing Company:
Owner:
Address:
City, State, Zip Code:
Phone #
Testers Phone #
Date:
This procedure is to determine whether the ( ATG) is operating properly. See PEI/RP1200 Section 8.2 for the proper inspection procedure.
Tank Number
Product Stored:
ATG Brand and Model
1. Tank Volume, gallons
2. Tank Diameter, inches
3. After removing the ATG from the tank, has it
been inspected and any damaged or missing
parts replaced?
4. Float moves freely on the stem without
5. Fuel float level agrees with the
value programmed into the console?
6. Water float level agrees with the value
programmed into the console?
7. Inch level from bottom of stem when 90%
alarm is triggered.
8. Inch level at which the overfill alarm
activates corresponds with value programmed
in the gauge?
9. Inch level from the bottom when the water
float first triggers an alarm.
10. Inch level at which the float alarm activates
corresponds with value programmed in the
gauge?
If any answers in Lines 3,4,5, or 6 are "NO" the system has failed the test.
TEST RESULTS
Comments:
Testers Name: Steven B. Martin Testers Signature:
IRON COUNTY ROAD DEPARTMENT
1105 NORTH BULLDOG ROAD
CEDAR CITY, UTAH
6000090
AES UTAH TESTER # UT 0121
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
BRETT GURNEY 385-602-4872
801-540-9258
3-7-2024
1
DSL
TLS 300C
11996
96
YES
YES
YES
YES
81
YES
2
YES
PASS
BATTERY BACKUP FUNCTIONS PROPERLY
SETUP REPORT PRINTED
Digitally signed by STEVEN B MARTIN
cn=STEVEN B MARTIN, o=AES, c=US
Date: 2024.03.15 11:25:51 -07'00'
Reason: I am the author of this document