DERR-2025-001580

If any answers in Questions 3,4,5,6,7,11,13 or 14 are No, the system has failed the test.
Overfill Alarm Inspection
Facility Information
Name:Fast Stop 1108 Certification/Inspection #:
Address:2615 E BENGAL BLVD, Cottonwood Heights, UT, 84121 State ID:4001183
Phone Number:Form Completed By:Larry Vasquez Date:02/06/2025
Overfill Alarm Information
This procedure is to determine wheather the high level alarm is operational and will trigger when the tank is no more than 90% full. See PEI/RP1200 Section 7.3 for
inspection procedure. This procedure is applicable to tank level monitor stems that touch the bottom of the tank when in place.
Tank #T1 RUL T2 PUL T3 DSL
Tank Facility ID T1 RUL T2 PUL T3 DSL
Product Stored Unleaded Premium Diesel
Tank Level Brand Veeder Root Veeder Root Veeder Root
Tank Level Model TLS-350 TLS-350 TLS-350
1.Tank Diameter, in 92.000 92.000 92.000
2. Actual Tank Capacity, gal 11550 8086 4691
3.Overfill alarm activates in the test mode at
the console?
Y Y Y
4.When activated, overfill alarm can be heard
or seen while delivering to the tank?
Y Y Y
5.After removing the probe, it has been inspected
and any damage or missing parts replaced?
Y Y Y
6.Float moves freely on stem without binding?Y Y Y
7.Moving product level float up stem triggers alarm?Y Y Y
8.Inch level from bottom of stem when 90% alarm is
triggered
90 90 90
9.Calculated tank volume from Question 8 10385 7263 4189
10.Tank % full 89.91 89.82 89.30
11.Is Question 10 less than 90%Y Y Y
12.Fuel float level on the console agrees with the
gauge stick reading?
Y Y Y
13. Overfill activates at 90% or less of tank capacity?Y Y Y
14.Fuel float level on the console agrees with the
gauge stick reading
Y Y Y
Test Results Pass Pass Pass
Comments
Operator Certification
Contractor Printed Name:Larry Vasquez Contractor Signature: