DERR-2025-000950

Tank # / Tank Facility ID / Product
Leak Detection:
UST Monthly Compliance Inspection
Facility Information
Name:Fast Stop 1109 Certification/Inspection #:55832
Address:6030 W 20800 N State ID:0100133
Phone
Number:Form Completed By:Larry Vasquez Date:10/22/2024
T2 DSL 1
T2 DSL 1
Diesel
T3 DSL 2
T3 DSL 2
Diesel
T5 DYE
DSL
T5 DYE
DSL
Dyed
Diesel
T6 ETH
FREE
T6 ETH
FREE
Ethanol
Free
Unleaded
T4 PUL
T4 PUL
Premium
Tanks:
1 Is release detection equip. operating w/o alarms or unusual conditions? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
2 Is tank free of water? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
3 Primary Tank Release Detection Method Inspected:Interstitial
Monitoring
Interstitial
Monitoring
Interstitial
Monitoring
Interstitial
Monitoring
Interstitial
Monitoring
4 Date of last passing result:10/22/2024 10/22/2024 10/22/2024 10/22/2024 10/22/2024
5 Are Inventories reconciled daily and are the variances within the guideline
set by the facility owner?
Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
Lines:
6 Are line leak detectors present? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
7 LD s operating properly (no slow flow)? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
8 Primary Line Release Detection Method Inspected Sump Sensor
Monitoring
Sump Sensor
Monitoring
Sump Sensor
Monitoring
Sump Sensor
Monitoring
Sump Sensor
Monitoring
9 Date of last passing result:10/22/2024 10/22/2024 10/22/2024 10/22/2024 10/22/2024
Fill/Overfill:
10 Fill caps, adapters, gaskets in good condition? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
11 Fills properly marked? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
12 Spill bucket free of liquid/debris? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
13 Spill bucket free of damage/drain work correctly? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
14 Does the spill bucket drain assembly work correctly? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
15 For double wall spill bucket, is the interstitial monitoring equipment
functioning, in good condition and not in alarm?
Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
16 Fill cap in place and sealed tightily? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
17 Overfill drop tube free of obstructions? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
Vapor:
18 Vapor cap in place and sealed tightly? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
19 Vapor recovery adapter intact? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
20 Vapor recovery lids painted orange? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
21 Is Vapor Bucket free of damage and free of liquid/debris? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
STP Secondary Containment:
22 Sump containment free of water/fuel/debris? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
23 STP and piping free of leaks and seeps? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
24 Sump containment free of damage? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
25 For DW containment with Brine, are levels correct? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
11/13/24, 9:57 AM Monthly Inspection UST CO
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Tank # / Tank Facility ID / ProductLeak Detection:
13
26 Sensors located @ lowest point in containment? Y N
NA
Y N
NA
Y N
NA
Y N
NA
Y N
NA
T1 RUL
T1 RUL
Unleaded

Tanks:
1 Is release detection equip. operating w/o alarms or unusual conditions? Y N NA
2 Is tank free of water? Y N NA
3 Primary Tank Release Detection Method Inspected:Interstitial
Monitoring
4 Date of last passing result:10/22/2024
5 Are Inventories reconciled daily and are the variances within the guideline set by
the facility owner? Y N NA
Lines:
6 Are line leak detectors present? Y N NA
7 LD s operating properly (no slow flow)? Y N NA
8 Primary Line Release Detection Method Inspected Sump Sensor
Monitoring
9 Date of last passing result:10/22/2024
Fill/Overfill:
10 Fill caps, adapters, gaskets in good condition? Y N NA
11 Fills properly marked? Y N NA
12 Spill bucket free of liquid/debris? Y N NA
13 Spill bucket free of damage/drain work correctly? Y N NA
14 Does the spill bucket drain assembly work correctly? Y N NA
15 For double wall spill bucket, is the interstitial monitoring equipment functioning, in
good condition and not in alarm? Y N NA
16 Fill cap in place and sealed tightily? Y N NA
17 Overfill drop tube free of obstructions? Y N NA
Vapor:
18 Vapor cap in place and sealed tightly? Y N NA
19 Vapor recovery adapter intact? Y N NA
20 Vapor recovery lids painted orange? Y N NA
21 Is Vapor Bucket free of damage and free of liquid/debris? Y N NA
STP Secondary Containment:
22 Sump containment free of water/fuel/debris? Y N NA
23 STP and piping free of leaks and seeps? Y N NA
24 Sump containment free of damage? Y N NA
25 For DW containment with Brine, are levels correct? Y N NA
26 Sensors located @ lowest point in containment? Y N NA
Dispensing Equipment:Qty:Facility Notes:
27 UDC free of water/fuel/debris? Y N NA
28 All meters/ piping free from leaks and seeps? Y N NA
29 UDC in good condition & free from damage? Y N NA
30 For DW containment with Brine, are levels correct? Y N NA
31 Sensors located lowest point in UDC? Y N NA
32 Shear valves properly set and secured? Y N NA
33 Nozzles, swivels, hoses and connectors free of
leaks? Y N NA
34 All product and whip hoses in good condition? Y N NA
Cathodic Protection:
35 Rectifier is on? Y N NA
Contractor Signature:Date:10/22/2024
Printed Name:Larry Vasquez Certification Number:
11/13/24, 9:57 AM Monthly Inspection UST CO
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Automatic Tank Gauge Inspection
ATG 1
ATG 1670
Facility Information
Name:Fast Stop 1109 Certification/Inspection #:55833
Address:6030 W 20800 N, Plymouth, UT, 84330 State ID:0100133
Phone Number:Form Completed By:Larry Vasquez Date:10/22/2024
ATG Console Inspection
Tank Level Monitor Brand :Veeder Root
1.Status upon Arrival:All Functions Normal
2.Status upon Departure:All Functions Normal
3.Is the display in good
condition and functioning?:
Yes
4.Is the keypad in good
condition?:
Yes
Tank Level Monitor Model :TLS-350
5.Are all indicator lights
functional?:
Yes
6.Is printer functional?:Yes
7.Back-up battery tested? (if
applicable)?:
Yes
8.Back-up battery voltage (if
applicable):
Tank Information
Probe and Programing Inspection:
9.Tank # T1 RUL T6 ETH FREE T3 DSL
2
T2 DSL
1 T4 PUL
10.Tank Facility ID T1 RUL T6 ETH FREE T3 DSL
2
T2 DSL
1 T4 PUL
11.Tank # per ATG T1 RUL T6 ETH FREE T3 DSL 2 T2 DSL T4 PUL
12.Product:Unleaded Ethanol Free
Unleaded Diesel Diesel Premium
13.Tank Volume, gallons 19761 7795 14543 14543 11593
14.Tank Dia/depth, inches 117.5 91.5 91.5 91.5 91.5
In-Tank Setup Parameters:
15.Thermal coefficient .000700 .000700 .000450 .000450 .000700
16.ATG Programmed Diameter 117.50 91.5 91.50 91.50 91.5
17.Number of points on profile 4 4 4 4 4
18.Full volume on profile 19761 7795 14543 14543 11593
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19.After removing the probe from the tank, it has been inspected
and any damaged or missing parts replaced?
Yes Yes Yes Yes Yes
20.Do floats move freely along the stem without binding?Yes Yes Yes Yes Yes
21.Does product level match console value?Yes Yes Yes Yes Yes
22.Does water level match console value?Yes Yes Yes Yes Yes
23.Water warning (inches)(1")1.5%22 1.5%22 1.5%22 1.5%22 1.5%22
24.High water limit (inches)(1.5")2%22 2%22 2%22 2%22 2%22
25.Does console water alarm trigger at programmed level?Yes Yes Yes Yes Yes
26.Programmed Overfill Limit (90%)90 90 90 90 90
27.Does console overfill alarm trigger at programmed level?Yes Yes Yes Yes Yes
28.Programmed High Product Limit (95%)95 95 95 95 95
29.Does console high product alarm trigger at programmed level?Yes Yes Yes Yes Yes
30.Low Product (15% of tank volume or 15" whichever is greater)15 15 15 15 15
31.Tank test program enabled?Yes Yes Yes Yes Yes
32.Tank Test Method?Interstitial Select Interstitial Interstitial Interstitial
33.Tank Test Rate 0.2 0.2 0.2 0.2 0.2
34.Test duration (hrs)CONT CONT CONT CONT CONT
35.12 months of tank test history present?Yes Yes Yes Yes Yes
Lines:
36.Electronic Line Leak Type PLLD PLLD PLLD PLLD PLLD
37.Line # and label in ATG (Q1, Unleaded)Q1 RUL Q6 ETH FREE Q2 DSL Q2 DSL Q3 PUL
38.Line Test Rate 3 GPH 3 GPH 3 GPH 3 GPH 3 GPH
39.12 months of line test history present?Yes Yes Yes Yes Yes
40.Test Result Pass Pass Pass Pass Pass
Probe and Programing Inspection:
9.Tank # T5 DYE DSL
10.Tank Facility ID T5 DYE DSL
11.Tank # per ATG T5 DYE DSL
12.Product:Dyed Diesel
13.Tank Volume, gallons 7795
14.Tank Dia/depth, inches 91.5
In-Tank Setup Parameters:
15.Thermal coefficient .000450
16.ATG Programmed Diameter 91.5
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Pass/Fail Criteria: if any of questions 19, 20 ,21 & 22 are No, then the system has failed the test.
Comment
Operator Certification
Contractor Signature:Printed Name:Larry Vasquez
17.Number of points on profile 4
18.Full volume on profile 7795
19.After removing the probe from the tank, it has been inspected and any damaged or missing parts replaced?Yes
20.Do floats move freely along the stem without binding?Yes
21.Does product level match console value?Yes
22.Does water level match console value?Yes
23.Water warning (inches)(1")1.5%22
24.High water limit (inches)(1.5")2%22
25.Does console water alarm trigger at programmed level?Yes
26.Programmed Overfill Limit (90%)90
27.Does console overfill alarm trigger at programmed level?Yes
28.Programmed High Product Limit (95%)95
29.Does console high product alarm trigger at programmed level?Yes
30.Low Product (15% of tank volume or 15" whichever is greater)15
31.Tank test program enabled?Yes
32.Tank Test Method?Interstitial
33.Tank Test Rate 0.2
34.Test duration (hrs)CONT
35.12 months of tank test history present?Yes
Lines:
36.Electronic Line Leak Type PLLD
37.Line # and label in ATG (Q1, Unleaded)Q5 DYE DSL
38.Line Test Rate 3 GPH
39.12 months of line test history present?Yes
40.Test Result Pass
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Automatic Tank Gauge Sensor
ATG 1
Facility Information
Name:Fast Stop 1109 Certification/Inspection #:55830
Address:6030 W 20800 N, Plymouth, UT, 84330 State ID:0100133
Phone Number:Form Completed By:Larry Vasquez Date:10/22/2024
Sensor: #
Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
Model:794380 794380 794380 794380 794380
Type:Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Location:STP STP STP STP STP
Test Liquid, Fuel(F) and/or Water(W):Both Both Both Both Both
Is the ATG console clear of any active
or recurring warnings or alarms
regarding sensor?
If sensor is in alarm and functioning
indicate why below:
Y Y Y Y Y
Is the sensor alarm circuit operational?Y Y Y Y Y
Has the sensor been inspected and in
good operating condition?
Y Y Y Y Y
When placed in the test liquid does the
sensor trigger an alarm?
Y Y Y Y Y
Sensor removed for testing?Y Y Y Y Y
When an alarm is triggered, is the
sensor properly identified on the ATG
console?
Y Y Y Y Y
Sensor returned to proper placement
and verified to be functional after
testing?
Y Y Y Y Y
Any "No" answers above indicates the
sensor fails the test.
Test Result Pass Pass Pass Pass Pass
Sensor: #
Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
11/13/24, 10:11 AM ATG Sensor
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Model:794380 794380 794380 794380 794380
Type:Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Location:STP STP Interstice interstice interstice
Test Liquid, Fuel(F) and/or Water(W):Both Both Both Both Both
Is the ATG console clear of any active
or recurring warnings or alarms
regarding sensor?
If sensor is in alarm and functioning
indicate why below:
Y Y Y Y Y
Is the sensor alarm circuit operational?Y Y Y Y Y
Has the sensor been inspected and in
good operating condition?
Y Y Y Y Y
When placed in the test liquid does the
sensor trigger an alarm?
Y Y Y Y Y
Sensor removed for testing?Y Y Y Y Y
When an alarm is triggered, is the
sensor properly identified on the ATG
console?
Y Y Y Y Y
Sensor returned to proper placement
and verified to be functional after
testing?
Y Y Y Y Y
Any "No" answers above indicates the
sensor fails the test.
Test Result Pass Pass Pass Pass Pass
Sensor: #
Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
Model:794380 794380 794380 794380 794380
Type:Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Location:interstice interstice interstice interstice UDC
Test Liquid, Fuel(F) and/or Water(W):Both Both Both Both Both
Is the ATG console clear of any active
or recurring warnings or alarms
regarding sensor?
If sensor is in alarm and functioning
indicate why below:
Y Y Y Y Y
Is the sensor alarm circuit operational?Y Y Y Y Y
Has the sensor been inspected and in
good operating condition?
Y Y Y Y Y
When placed in the test liquid does the
sensor trigger an alarm?
Y Y Y Y Y
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Sensor removed for testing?Y Y Y Y Y
When an alarm is triggered, is the
sensor properly identified on the ATG
console?
Y Y Y Y Y
Sensor returned to proper placement
and verified to be functional after
testing?
Y Y Y Y Y
Any "No" answers above indicates the
sensor fails the test.
Test Result Pass Pass Pass Pass Pass
Sensor: #
Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
Model:794380 794380 794380 794380 794380
Type:Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Location:UDC UDC UDC UDC UDC
Test Liquid, Fuel(F) and/or Water(W):Both Both Both Both Both
Is the ATG console clear of any active
or recurring warnings or alarms
regarding sensor?
If sensor is in alarm and functioning
indicate why below:
Y Y Y Y Y
Is the sensor alarm circuit operational?Y Y Y Y Y
Has the sensor been inspected and in
good operating condition?
Y Y Y Y Y
When placed in the test liquid does the
sensor trigger an alarm?
Y Y Y Y Y
Sensor removed for testing?Y Y Y Y Y
When an alarm is triggered, is the
sensor properly identified on the ATG
console?
Y Y Y Y Y
Sensor returned to proper placement
and verified to be functional after
testing?
Y Y Y Y Y
Any "No" answers above indicates the
sensor fails the test.
Test Result Pass Pass Pass Pass Pass
Sensor: #
Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
Model:794380 794380 794380 794380 794380
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Type:Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Non-
discriminating
Location:UDC UDC UDC UDC UDC
Test Liquid, Fuel(F) and/or Water(W):Both Both Both Both Both
Is the ATG console clear of any active
or recurring warnings or alarms
regarding sensor?
If sensor is in alarm and functioning
indicate why below:
Y Y Y Y Y
Is the sensor alarm circuit operational?Y Y Y Y Y
Has the sensor been inspected and in
good operating condition?
Y Y Y Y Y
When placed in the test liquid does the
sensor trigger an alarm?
Y Y Y Y Y
Sensor removed for testing?Y Y Y Y Y
When an alarm is triggered, is the
sensor properly identified on the ATG
console?
Y Y Y Y Y
Sensor returned to proper placement
and verified to be functional after
testing?
Y Y Y Y Y
Any "No" answers above indicates the
sensor fails the test.
Test Result Pass Pass Pass Pass Pass
Sensor: #
Brand:Veeder Root Veeder Root
Model:794380 794380
Type:Non-
discriminating
Non-
discriminating
Location:UDC UDC
Test Liquid, Fuel(F) and/or Water(W):Both Both
Is the ATG console clear of any active or recurring warnings or alarms regarding sensor?
If sensor is in alarm and functioning indicate why below:
Y Y
Is the sensor alarm circuit operational?Y Y
Has the sensor been inspected and in good operating condition?Y Y
When placed in the test liquid does the sensor trigger an alarm?Y Y
Sensor removed for testing?Y Y
When an alarm is triggered, is the sensor properly identified on the ATG console?Y Y
Sensor returned to proper placement and verified to be functional after testing?Y Y
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Any "No" answers above indicates the sensor fails the test.
Test Result Pass Pass
Comment
Operator Certification
Contractor Signature:Printed Name:Larry Vasquez
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Leak Detector
Facility Information
Name:Fast Stop 1109 Certification/Inspection #:55829
Address:6030 W 20800 N, Plymouth, UT, 84330 State ID:0100133
Phone Number:Form Completed By:Larry Vasquez Date:10/22/2024
Tank Information
Tank #:T1 RUL T2 DSL 1 T3 DSL 2 T4 PUL T5 DYE DSL
Capacity:19761 14543 14543 11593 7795
Product:Unleaded Diesel Diesel Premium Dyed Diesel
Tank #:T6 ETH FREE
Capacity:7795
Product:Ethanol Free
Unleaded
Line #:Q1 RUL Q2 DSL Q3 PUL Q4 DYE DSL Q5 ETH FREE
Line Type:Pressure Pressure Pressure Pressure Pressure
LD Brand:Veeder Root Veeder Root Veeder Root Veeder Root Veeder Root
LD Model:PLLD PLLD PLLD PLLD PLLD
Serial #:0 0 0 0 0
Associated Tank:T1 RUL,T1 RUL T2 DSL 1,T3 DSL 2 T4 PUL,T4 PUL T5 DYE DSL,T5 DYE
DSL
T6 ETH FREE,T6 ETH
FREE
Resiliency (ml):0 0 0 0 0
Check Valve Holding PSI:21 22 24 25 24
Opening Time:0 0 0 0 0
Result:Pass Pass Pass Pass Pass
Test Equip. Mfg.:Vaporless, LDT-890 Vaporless, LDT-890 Vaporless, LDT-890 Vaporless, LDT-890 Vaporless, LDT-890
Notes:
Tested per manufacturer specifications.
Contractor Signature:Printed Name:Larry Vasquez
Line Test
Facility Information
Name:Fast Stop 1109 Certification/Inspection #:55828
Address:6030 W 20800 N State ID:0100133
Phone Number:Form Completed By:Larry Vasquez Date:10/22/2024
Tank Test Information
Tank #:T1 RUL T2 DSL 1 T3 DSL 2 T4 PUL T5 DYE DSL
Capacity:19761 14543 14543 11593 7795
Product:Unleaded Diesel Diesel Premium Dyed Diesel

Tank #:T6 ETH FREE
Capacity:7795
Product:Ethanol Free
Unleaded
Line Test Information
Line #:Q1 RUL Q2 DSL Q3 PUL Q4 DYE DSL Q5 ETH FREE
LineType:Pressure Pressure Pressure Pressure Pressure
Line Material:DW Flex DW Flex DW Flex DW Flex DW Flex
Line ID Size (in):2 2 2 2 2
Line Length (ft):260 450 260 140 180
Pump Type:FE Petro FE Petro FE Petro FE Petro FE Petro
Associated Tank:T1 RUL,T1 RUL T2 DSL 1,T3 DSL
2
T4 PUL,T4 PUL T5 DYE DSL,T5
DYE DSL
T6 ETH FREE,T6
ETH FREE
Test Equip. Mfg.:Triangle Triangle Triangle Triangle Triangle
Test Pressure (PSI):50 50 50 50 50
Initial Cyl. Level:400 260 410 450 300
Final Cyl. Level:400 260 380 450 280
Change in Time (mins):15 15 15 15 15
Change in Vol:0.0000 0.0000 -30.0000 0.0000 -20.0000
Change in Temp (F):0 0 0 0 0
Coeff. Of Thermal Expansion (g/F):0.00070 0.00045 0.00070 0.00045
Line Vol (gal):42.41 73.40 42.41 22.84 29.36
Leak Rate (GPH):0.0000 0.0000 -0.0317 0.0000 -0.0211
Result:Pass Pass Pass Pass Pass
Notes
TIGHTNESS TESTING CERTIFICATION
CGRS certifies that the systems in the above table have been tested utilizing leak detection methods which meet the prescribed leak rate testing
standard of 0.10 gph with a minimum probability of detection of 95% and a 5% probability of a false alarm. CGRS further certifies that the protocol for
each test method was strictly adhered to, and that all precision tightness testing performed by CGRS was conducted in accordance with EPA 40 CFR
parts 280.43(c) and 280.44(b) and the National Fire Protection Association, Bulletin NFPA 329 criteria.
11/13/24, 10:11 AM Line Test
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Contractor Printed Name:Larry Vasquez Contractor Signature:
Certification Number:TMI-301
11/13/24, 10:11 AM Line Test
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