HomeMy WebLinkAboutDERR-2025-000810Page 'l ol ?Utah Department of Environmental Quality
UST Release Detection lnspection
0100222
Ownership of Tanks Locatlon of Tanks
UTAH STATE FUEL NEWVORK UDOT STA″1435
4315S2700ヽV ,050 S CENTER ST
SALT LAKE CITY IUT 134129 WELLSVILLE IUT 34339
OP A:BRヒ ::OURNEY I(301)957‐7261 OP B:OEORGE STURM I(385)602●872
VeJ,tests on tank data sheet
are current and on fl[e r@ tto ue Si。91e●valed Spll buckets:Yes No (@
くコ5) No NA rγ es No NA
Line tighlioss(suclioi 3yr)Yos No NA ③ No NA
Yes ご
“
ジ NA
Cathod c PrOted on Yes No ffiD
Complet€ to..ach tank.1ム##Capacity ol tank (9allons)乙cc‐ヽoo0
0.こ ぅ・ ヽ
oare lasl used/depth ol producr
Typ€ o, spill preveniion device ヽい ヽ3 うO SS
Oouble Wallod spill buctel qauoe rs
checked mo.thly and vald:4@ uo Ha o No NA Ves No NA Yes No NA Yes No NA Yes No NA
Spillbuckel is clean, inbcl etc:
`ι
tt No c No
Typ€ oI overfll Prevention device:As‐へヽo
Ovedll alam {audibl€ or visible) is p.ope,ly loc.ted $ d€liv€ry driver en hear d * il, and is cbady identjfied:Yes No @
STP Flex pretection rehod (Sump.
Cathodic Protoclion, lsolated, Bered):t*^{ヽ褻¨'Coldnrenl sumps dry:(tes) No NA c No NA Ves No NA Yes No NA
Sliage 1 Vapd Re@very 2pt coax@E 2口 03None
Prcssure Venl Valve is on venls:O No NA くこg, No NA Ves No NA Ves No NA Yes No NA Ves No NA
Compl.t. lor.ech dlBp.nser `l‐` ヽ/1##,Flex p.otecrio relhod (UOC,
Cathodic Poieclion, lsolated, 8@ted)uoι t4ぱ
@NoNA O No NA Yes No NA Ves No NA Ves No NA Ves No NA
DW piping have jumpeB in place:Yes No 8,Yes Noこ9 Yes No NA Ves No NA Yes No NA Yes No NA
Farc valve amhored, lo@ted bdw
grade, 6nd wilh@t ball valw く(:メ No NA (FJ No NA Ves No NA Yes No NA Yes No NA Yes No NA
Addilional dlsp.ns.r quoBllon."″″`F ex protmion methOd(UDC
Cathodic Proleclion lsolated Booled〉
Yes No NA Ves No NA Yes No NA Yes No NA
OW piping havejumpers in pla@:Yes No NA Yes No NA Yes No NA Yes No NA Ves No NA Yes N。NA
Firc valve anchorcd, l@ted bdw
grade, and no ball valve:
Yes No NA Yes No NA Yes No NA Ves No NA Yes No NA
lmpressed Currehl Calhodlc Proiectlon last thrso dalos rectilier checked:
Financla[Responsibiity(state us●on〔y)
パの熙ヽ NO FR Method IMethod OK?I Ves No by:
O NO
'C'Operato6 tain6d or unmann6d sil6 sign 6 visibl€?Yos No ol
t A-l-'E^ rnspe.led this ra.irty on t-zl-zr.lflhe site is unmanned and dispensestuel, d@s ithave
an eme€ency shulof, device?11) No NA S穎 lk_TI
02t3Monthry cnecklist available and complsie?ヽ1, No O/OS¨
Page 2 ot L
l, Monlhly monirorlng
L lnr€lsriar monibnng
Tank and Piping Release Detection 0100222
Tants lnit.ll.d !lr.r ocrobor 1 , 2oo8 mu do rot.Gtliial onilo.i.g.
llsrR
Automatic Tank Gauging/lnterstitial Monitoring
ia.nufacturar and Mod€l olsyslem:
Cirda Yos o. No fo. 6&h qu€3tibn. h th6 tssl cotumn. oqtain and ir.ntly by tank any 6xc€plions !o th€ ansr.6 givon in ths frst colJmn.
Typ€ or lM dcumonlation us6d:C@ ManuarTyp. ol @ndary @nt inrn6nl us€d:
systom is cspabb ol dslo.ting a rel€aso ol rogularod subsianGs lrom any
portion ol ir€ primary lanldpipng wit n one monh of l6base:
ATG corcolo or oth6r oquagnonl us€d lo lat€ roadin€F and porlorm lo6ts ls
ad6quat6, 6@asible, arld op€ra!,onall
Th6 lank Ms frlbd to at l6ast th6 minimum l€velrsqLrlrsd lo ensuB a valid t6a*
tost, and lhs lank sizo is witiin he alk{od uppor a.rd l(rer sizo li6ils:
IdPrtysL.!.ltrsbl
Shoe r.tult of monhorhg for..ch t nl tor th. l..t 12 monrh.. lndlcd. P.!, F.ll. lnv.lld. d No R..ul6 tor..ch moith. For ATG Shddo6 t .tr..hd th. hlghrt frodsct Lv.l i..Ld to. ..ch month.
an Auromatic Lire Leak Derecior and one other lom ol l€ak doloclion
lndicate the method used:
piping musl b€ lssl.d evsry 3 yoals or hava monlhly mnilding. li srt€ suclion, bai d€bc-ton is d€l€d€d.
Lln. L..t D.t.cior l..tlno Plpln! lnlt.ttod.lt.r Oclobsr l, 2008 mo.r do l.toBrlrl.l ilo.ltorlng.
Ta.t{;1 t-". c 'to - Lo..!
Ve,1070018
I lnl6Blitial Monalo.ine