DERR-2025-001189

1
UNDERGROUND STORAGE TANK CLOSURE PLAN (rev. 7/13) FACILITY ID# 5000169 …
LHD USE ONLY
Date Received
Reviewer
Date LHD Approved
Date mailed to State
Closure Plan prepared at the request of the owner/operator (identified below) by Russell Hicks
of (company name) Maverik, Inc. Phone # [phone]
Address 185 S. State Street, Suite 800 City Salt Lake City StateUT Zip84111
A Contractor may prepare this Closure Plan as the owner/operator's agent. In preparing the Closure Plan, the Contractor must act with
the owner/operator's knowledge and approval. The owner/operator must sign the Closure Plan. Submit Closure Plan to: DERR/UST,
P.O. Box 144840, Salt Lake City, Utah, 84114-4840
This Closure Plan is submitted in compliance with the requirements contained in 40 CFR 280 Subpart G and R311-204 (U.A.C.)
Piping closure only Tank # 1 2
Tank Type (Steel,FRP,etc.) Steel/Comp Steel/Comp
Piping Type (Steel,FRP,etc.) Flex plast Flex plast
Date Installed 5/21/2000 5/21/2000
Capacity 15,000 10,000
Substance stored* Gas Gas
Date last operated Current Current
Removal/In Place/Change in
Service (CIS)? Removed Removed
*Indicate the specific substance stored in each tank to be closed (gasoline, diesel, new oil, waste oil, etc.)
For waste oil tanks: Have degreasing or other types of solvents been stored or mixed with the waste oil?
Yes (identify if known) NA . No Not Known
Analysis for lead or other contaminants may be required prior to disposal of contaminated soil or other material. (Check with your
disposal facility.)
STATE USE ONLY
Date Received
Date Mailed to LHD
Date Received From LHD
Reviewer/Date Approved
Mgr. Review/Date
FACILITY INFORMATION
Tank Owner Maverik, Inc.Phone # [phone]
Address 185 S. State Street, Suite 800 City Salt Lake City
State
UT Zip 84111
Facility Name Maverik #249 Price
Address 295 E. Main Street City Price
State
UT Zip 84501
Contact person Russell Hicks Phone # [phone]
Total number of regulated underground tanks at this site 2
Total number of regulated underground tanks at this site to be closed 2
2/10/2025
DJW / 2/11/2025
2/11/2025
2

Before the closure plan is submitted for approval, the local health and fire departments where the facility is located
must be contacted.

CONTACT LOCAL HEALTH DISTRICT: Name of Dist. Utah DERR Date 2/10/25
Contact David Wilson Title Environmental Scientist Phone# [phone]
CONTACT LOCAL FIRE DEPT. Name of Dept. Price Fire Dept. Date 2/10/25
Contact Fitzgerald Peterson Title Fire Chief/Inspector Phone# [phone]
DISPOSAL INFORMATION
Tank(s) will be disposed at: Facility Stephensons Metal Recycling
Address 1780 Ridge Rd City Wellington State UT Zip 84542
Contact person Ryan or scale house Phone# [phone]
Product lines will either be: removed or cleaned, secured in place, and capped.
Vent lines will either be: removed or cleaned and secured open.
Piping will be disposed at: Facility City Sanitation
Address 780 S. 800 E. City Price State UT Zip 84501
Contact person Scale House Phone# [phone]
Tank(s) will be emptied by: company Maverik Logistics Phone# [phone]
Tank(s) will be cleaned by: company Sump and Trap Cleaning, LLC Phone# [phone]
Contaminated water in the tank/rinsate will be disposed at: Facility Sump and Trap Cleaning, LLC
Contact person Josh Greenwood Phone# [phone]
Tank(s) will be: purged or rendered inert by the following method: Dry Ice
Residual sludges will be disposed at the following facility: Sump and Trap Cleaning, LLC
Address 618 S. 4050 W. City Salt Lake City State UT Zip 84104
Contact person Josh Greenwood Phone# [phone]

FOR CLOSURE IN PLACE ONLY
For this closure method, you are subject to the requirements of UAC R315-302-2(6), which requires annotating the property title and
submitting documentation to the Division of Solid and Hazardous Waste (DSHW). For information on how to comply with these
requirements, contact the DSHW Solid Waste Landfills Section Manager at [phone].
Approval for in-place closure has been granted by the Local Fire Department. (Must submit approval in writing with Closure Plan)
Fire Dept. Phone# Contact person Date
Approval for in-place closure has been granted by the Local Health Department.
Health Dept. Phone# Contact person Date
Substance to be used to fill tanks:

TANK REMOVER Name Chad Russell Cert. # TR0385 Exp. Date 1/1/26
Company Direct Push Services, LLC Phone # [phone]
Address 2551 S. 800 W. City West Valley State UT Zip 84119
SOIL/GROUNDWATER SAMPLER Name Russell Hicks Cert. # GS1288 Exp. Date 2/15/26
Company Push Drilling, LLC Phone # [phone]
Address 852 Chelsea Dr. City Bountiful State UT Zip 84010
3
SITE ASSESSMENT
A site assessment must be performed for all UST closures and change-in-service. Site assessments must be performed as outlined in 40 CFR
280.72 and R311-205 (U.A.C.). If contamination is suspected, additional samples must be collected at the location where contamination is
most likely to be present. If groundwater is encountered, a soil sample must be collected, in the unsaturated zone, in addition to each
groundwater sample. Soil and groundwater samples must be analyzed for the compounds shown in the following table, using appropriate lab
methods.

Substance or
Product Type
Contaminant Compounds to be Analyzed for Each
Substance or Product Type
ANALYTICAL METHODS1 Soil, Groundwater
or Surface Water

Gasoline

Total Petroleum Hydrocarbons (purgeable TPH as gasoline
range organics C6 - C10)
EPA 8015 or EPA 8260
Benzene, Toluene, Ethyl benzene, Xylenes, Naphthalene,
(BTEXN) and MTBE
EPA 8021 or EPA 8260

Diesel
Total Petroleum Hydrocarbons (extractable TPH as diesel
range organics C10 – C28)
EPA 8015

Benzene, Toluene, Ethyl benzene, Xylenes, and Naphthalene
(BTEXN)
EPA 8021 or EPA 8260

Used Oil
Oil and Grease (O&G) or
Total Recoverable Petroleum Hydrocarbons (TRPH)
EPA 1664 or
EPA 1664 (SGT*)
Benzene, Toluene, Ethyl benzene, Xylenes, Naphthalene
(BTEXN) & MTBE; and Halogenated Volatile Organic
Compounds (VOX)
EPA 8021 or EPA 8260
New Oil

Oil and Grease (O&G) or
Total Recoverable Petroleum Hydrocarbons (TRPH)
EPA 1664 or
EPA 1664 (SGT*)
Other Type of analyses will be based upon the substance or product
stored, and as approved by the DERR Division Director
Method will be based upon the
substance or product type

Unknown
Total Petroleum Hydrocarbons (purgeable TPH as gasoline
range organics C6 - C10)
EPA 8015 or EPA 8260

Total Petroleum Hydrocarbons (extractable TPH as diesel
range organics C10 – C28)
EPA 8015

Oil and Grease (O&G) or
Total Recoverable Petroleum Hydrocarbons (TRPH)
EPA 1664 or
EPA 1664 (SGT*)
Benzene, Toluene, Ethyl benzene, Xylenes, and Naphthalene
(BTEXN) and MTBE; and Halogenated Volatile Organic
Compounds (VOX)
EPA 8021 or EPA 8260

1 The following modifications to these certified methods are considered acceptable by the DERR Division Director:
• Dual column confirmation may not be required for TPH and BTEXN/MTBE analysis.
• A micro-extraction or scale-down technique may be used for aqueous samples, but only for the determination of extractable TPH as diesel range
organics (C10 – C28).
• Hexane may be used as an extraction solvent.
• *Silica Gel Treatment (SGT) may be used in the determination of Total Recoverable Petroleum Hydrocarbons.

NOTE: The sample preparation method and any modification(s) to a certified method must be reported by the laboratory.

4
CONTAMINATED MATERIALS MUST BE DISPOSED AT AN ACCEPTABLE FACILITY:

All materials generated from UST closures must be managed and disposed in a manner that does not place those materials in direct contact
with the environment. On-site stockpiling of contaminated soils may be required prior to any soil management activities. Any person
providing remedial assistance for a fee, including aeration and over-excavation (of more than 50 yd3), must be a Certified UST Consultant.
Contaminated soils generated as part of tank removal are to be disposed at the following facility: Republic Services ECDC
Address 1111 W. Hwy 123 City East Carbon
State
UT Zip 84520
Contact person Richard McMullen Phone [phone]

Complete the Facility Site Plat and Sample Information Table on pages 4 and 5 to provide site assessment information.

CONTAMINATION INFORMATION
If contamination at the facility is suspected or confirmed, the information must be reported to the DERR Division Director at (801) 536-
4100 within 24 hours. The Division of Water Quality must be notified at [phone] if Free Product is encountered or if surface water
has been impacted. If contamination is confirmed, any person assisting in the remediation process for a fee must be a Certified UST
Consultant.
SAMPLE INFORMATION TABLE
Complete table for all samples to be taken for closure.
1 Soil (SS), Groundwater (GW), or Unified Soil Classification (USC). 2 Approx. depth in feet below grade. The required minimum site assessment samples must be taken at 0-2 feet below the backfill/native soil interface. 3 Contaminant compounds to be analyzed for each sample (from table on p. 3). 4 Appropriate analysis methods for contaminant compound(s) in each sample (from table on p. 3).
Sample
#
Substance
stored in
tank
Sample
type1 Depth2 Compounds3 Analysis method(s)4
SS-1 Gas SS ~10' MBTEXN, TPH-GRO 8260B
SS-2 Gas SS ~10' MBTEXN, TPH-GRO 8260B
SS-3 Gas SS 3-5' MBTEXN, TPH-GRO 8260B
SS-4 Gas SS 3-5' MBTEXN, TPH-GRO 8260B
GW-1 Gas GW ~11' MBTEXN, TPH-GRO 8260B
GW-2 Gas GW ~11' MBTEXN, TPH-GRO 8260B
USC-1 USC ~10' Soil Class USC
USC-2 USC 3-5' Soil Class USC

30
5000169 R. Hicks 2-9-25
x
x
SS-4
USC-2
Tan
k

#
1

1
5
K

G
a
s
Tan
k

#
2

1
0
K

G
a
s
SS-3
Fuel Area Canopy
SS-1
US C-1
SS-2
GW-1
GW-2
Concrete Pad Areas
Maverik #249
295 E. Main St.
Price, U T
30
0

E
a
s
t
Main Street
Dr
i
v
e
w
a
y

Ap
p
r
o
a
c
h
Driveway Approach Driveway Approach
6

Approximate depth to groundwater in the vicinity of the tanks: ~10feet.
Regional groundwater flow direction: S
State Certified Laboratory to be used: Chemtech-Ford Laboratories
Address 9632 S. 500 W. City Sandy
State
UT Zip 84070
Contact Person Mark Broadhead Phone [phone]

I certify under penalty of law that I am the owner/operator of the tank(s) referenced above and that I am familiar with
the information on this form and that it is true, accurate and complete, and further, that the procedures described herein
will be followed during tank closure.

Signature of tank owner
Full Name of tank owner Date

Please explain any unusual or extenuating circumstances expected regarding the site assessment or closure:

2/10/25Maverik, Inc. (Russell Hicks)