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Home My WebLink AboutDERR-2025-000311 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 PRODUCT PIPING INTEGRITY TESTING Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 This procedure is to test the integrity of product piping. Tests were performed with Petro-Tite line tester. Tank Number 1 Product Stored Red DSL Piping Run Supply Piping Type D/W FRP Test Pressure (PSI) 15 Test Duration (minutes) 30 Leak Rate (GPH) 0.002 Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Tester’s Name Taber DeHart, UT-0394 Tester’s Signature DSL Transition Sump Transition Sump Transition Sump Transition Sump Spill Bucket 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 AUTOMATIC TANK GAUGE OPERATION INSPECTION Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 This procedure is to determine whether the automatic tank gauge (ATG) is operating properly. See PEI/RP1200 Section 8.2 for the inspection procedure. This procedure is applicable to tank monitor stems the touch the bottom of the tank when in place. Tank Number 1 Product Stored Red DSL ATG Brand and Model TLS 350 1. Tank Volume, gallons 15,104 2. Tank Diameter, inches 119 5/8 3. After removing the ATG from the tank, it has been inspected and any damaged or missing parts replaced? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. Float moves freely on the stem without binding? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. Fuel float level agree with the value programmed into the console? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 6. Water float level agree with the value programmed into the console? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 7. Inch level from the bottom of the stem when 90% alarm is triggered? 99 5/8 8. Inch level at which the overfill alarm activates corresponds with the value programmed in the gauge? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 9. Inch level from the bottom when the water float first triggers an alarm? 1 10. Inch level at which the water float alarm activates corresponds with the value programmed in the gauge? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No If any answers in Lines 3, 4, 5, or 6 are "No" the system has failed the test. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Battery OK Tester’s Name Taber DeHart, UT-0394 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 LIQUID SENSER FUNCTIONALITY TESTING Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 This procedure is to determine whether liquid sensors, located in the interstitial spaces of the UST systems, are able to det ect the presence of water and fuel. See PEI/RP1200, Section 8.3 for the test procedure. Sensor Location L1 Noth STP L2 South STP L3 INT L5 Pump Sump L6 Trans Sump L7 East Gen Sump L8 Middle Gen Sump Product Stored Red DSL Red DSL Red DSL Red DSL Red DSL Red DSL Red DSL Type of Sensor ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating Test Liquid ☒ Water ☐ Product ☒ Water ☐ Product ☒ Water ☐ Product ☒ Water ☐ Product ☒ Water ☐ Product ☒ Water ☐ Product ☒ Water ☐ Product Is the ATG Console clear of any active or recurring warnings or alarms regarding the leak sensor? If the sensor is in alarm and functioning, indicate why. ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No Is sensor alarm circuit operational? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No Has sensor been inspected and in good operating condition? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No When placed in test liquid, does the sensor trigger an alarm? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No When alarm is trigger, is the sensor identified on the ATG console? ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No ☒ Yes ☐ No Any “No” answers indicate the sensor fails the test. Test Results: ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☒ Pass ☐ Fail Comments: No sensor programed for L4. Tester’s Name: Taber DeHart, UT-0394 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 LIQUID SENSER FUNCTIONALITY TESTING Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 This procedure is to determine whether liquid sensors, located in the interstitial spaces of the UST systems, are able to det ect the presence of water and fuel. See PEI/RP1200, Section 8.3 for the test procedure. Sensor Location L9 West Gen Sump L10 Broiler Sump Product Stored Red DSL Red DSL Type of Sensor ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☒ Non-Discrimi- nating ☐ Discriminating ☐ Non-Discrimi- nating ☐ Discriminating ☐ Non-Discrimi- nating ☐ Discriminating ☐ Non-Discrimi- nating ☐ Discriminating ☐ Non-Discrimi- nating ☐ Discriminating ☐ Non-Discrimi- nating Test Liquid ☒ Water ☐ Product ☒ Water ☐ Product ☐ Water ☐ Product ☐ Water ☐ Product ☐ Water ☐ Product ☐ Water ☐ Product ☐ Water ☐ Product Is the ATG Console clear of any active or recurring warnings or alarms regarding the leak sensor? If the sensor is in alarm and functioning, indicate why. ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No Is sensor alarm circuit operational? ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No Has sensor been inspected and in good operating condition? ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No When placed in test liquid, does the sensor trigger an alarm? ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No When alarm is trigger, is the sensor identified on the ATG console? ☒ Yes ☐ No ☒ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No ☐ Yes ☐ No Any “No” answers indicate the sensor fails the test. Test Results: ☒ Pass ☐ Fail ☒ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail ☐ Pass ☐ Fail Comments: Tester’s Name: Taber DeHart, UT-0394 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 OVERFILL ALARM OPERATION INSPECTION Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 This procedure is to determine whether the automatic tank gauge (ATG) is operating properly. See PEI/RP1200 Section 8.2 for the inspection procedure. This procedure is applicable to tank monitor stems the touch the bottom of the tank when in place. Tank Number 1 Product Stored Red DSL ATG Brand and Model TLS 350 1. Tank Volume, gallons 15,104 2. Tank Diameter, inches 119 5/8 3. Overfill alarm activates in the test mode at the console? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 4. When activated, overfill alarm can be heard or seen while delivering to the tank? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 5. After removing the probe from the tank, it has been inspected and any damaged or missing parts replaced? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 6. Float moves freely on stem without binding? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 7. Moving product level float up the stem trigger alarm? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 8. Inch level from bottom of stem when 90% alarm is triggered? 99 5/8 9. Tank volume at inch level in Line 8. 13,581 10. Calculate (Line 9 / Line 1) X 100 89.92 11. Is line 10 less than 90%? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 12. Fuel float level on the console agrees with the gauge stick reading? ☒Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No 13. Overfill alarm activates at any product level above 90% tank capacity? ☐Yes ☒No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No If any answers in Lines 3, 4, 5, 6, 7, or 11 are "No," or Line 13 is “Yes,” the system has failed the test. Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail ☐Pass ☐Fail Comments: Tester’s Name Taber DeHart, UT-0394 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 SPILL BUCKET INTEGRITY TESTING HYDROSTATIC TEST METHOD SINGLE- AND DOUBLE-WALLED VACUUM TEST METHOD Facility Name: Holy Cross Hospital – Mountain Point Owner: Catholic Health Initiative CO dba Holy Cross Address: 3000 Triumph Boulevard Address: 1050 East South Temple City, State, Zip: Lehi, Utah 84043 City, State, Zip: Salt Lake City, Utah 84102 Facility I.D.#: 1000924 Phone #: 801-230-2977 Testing Company: Westech Phone #: 801-266-2545 Date: 10/16/24 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 Product Stored Red DSL Spill Bucket Capacity 5-Gallon Manufacturer 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 9 1/16” Test Start Time 9:52 Ending Level 9 1/16” Test End Time 10:52 Test Period 1 Hour Level Change 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: *All liquids and debris must be disposed of properly Tester’s Name Taber DeHart, UT-0394 Tester’s Signature