DERR-2025-001581

Tank # / Tank Facility ID / ProductLeak Detection:
3
UST Monthly Compliance Inspection
Facility Information
Name:Fast Stop 1108 Certification/Inspection #:57808
Address:2615 E BENGAL BLVD State ID:4001183
Phone
Number:Form Completed By:Larry Vasquez Date:01/02/2025
T3 DSL
T3 DSL
Diesel
T2 PUL
T2 PUL
Premium
T1 RUL
T1 RUL
Unleaded
Tanks:
1 Is release detection equip. operating w/o alarms or unusual conditions? Y N NA Y N NA Y N NA
2 Is tank free of water? Y N NA Y N NA Y N NA
3 Primary Tank Release Detection Method Inspected:CSLD CSLD CSLD
4 Date of last passing result:01/02/2025 01/02/2025 01/02/2025
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
Lines:
6 Are line leak detectors present? 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
8 Primary Line Release Detection Method Inspected Annual Line Test Annual Line Test Annual Line Test
9 Date of last passing result:01/02/2025 01/02/2025 01/02/2025
Fill/Overfill:
10 Fill caps, adapters, gaskets in good condition? Y N NA Y N NA Y N NA
11 Fills properly marked? 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
13 Spill bucket free of damage/drain work correctly? 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
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
16 Fill cap in place and sealed tightily? 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
Vapor:
18 Vapor cap in place and sealed tightly? Y N NA Y N NA Y N NA
19 Vapor recovery adapter intact? Y N NA Y N NA Y N NA
20 Vapor recovery lids painted orange? 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
STP Secondary Containment:
22 Sump containment free of water/fuel/debris? 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
24 Sump containment free of damage? 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
26 Sensors located @ lowest point in containment? Y N NA Y N NA 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:01/02/2025
Printed Name:Larry Vasquez Certification Number:
1/31/25, 3:29 PM Monthly Inspection UST CO
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I Facility Name f'evS( $-tt>P (fo i
UST Operator Inspection -Utah
YEAR 20-2.S
Facility ID
!Address ?..C ( S' _&._ t1o (j. ( ar (/2 ~ I Primary Class B Operator
NAME(S) AND INITIALS OF PERSO~(S) CONDUCTING MONTHLY INSPECTIONS:
L (,t. "" r vc:: .• s'-v et: 1 r/"
Please respond to All of the following questions with a Y (Yes), N (No), or NA (Not Applicable) answer.
-
• Months of the Current Year J F M A M J J A S O N I D
'
I Monthly Inspection -Release Detection
1 'Release detection equipment is operating with no alarms or other unusual
l
I y I
I operating conditions.
1 2 1Records of release detection (tanks and piping) are reviewed and current. \/ i
I Monthly Inspection -Spill Prevention Equipment ..
.,
.) Equipment is undamaged, intact and free from defects . y
4 Equipment is free from debris, water, or product. V
5 Fill Pipe is unobstructed. N
I 6 Fill cap is un-broken and is securely on the fill pipe. y
7 Double walled spill prevention equipment -Interstitial area is free from leaks. nv...
I Initials of person performing Inspection. Lv
Annual Inspection -Containment Sumps , •'f.' Date of annual Inspection /-:J-lS
-;--I Secondary Containment Sumps Visual Inspection of sump indicates no damage and it is free from debris, water and fuel. y
(STP, Dispenser and Transition) The penetration fittings for conduits and piping entering the STP Sumps are intact. v
1 9 I Double Walled Sumps Interstitial area is free from leaks. n"-
1 10 Hand-held release detection Hand-held release detection equipment (bailer, gauge stick, etc.) is serviceable and i equipment operable.
I certify under penalty of law that I am the Class B Operator referenced above and that I am familiar with information on this form
and that it is true, accurate and was completed in accordance with R311-203-7.
Signature of the Primary Class B Operator (Sign this document after the last inspection of the Current Year) Date
I
B Operator#
Comments/Follow up:
Turn ovc,· for record ot· Jntenti1i,d ''"""'" 111g visual inspections 11nd Impressed Current rcctilicr checks.
I
UST Operator Inspection -Utah-Page 2 of 2
If you perform Interstitial Monitoring on your tanks and/or piping and use a visual check rather than sump or
interstitial sensors for your monthly leak detection, complete the table to document the monthly visual checks.
Months of the Current Year J F M A M J J A s 0 N
1 Visual check ~f the interstitial space of the double-walled tank Indicated no (\,
release or unusual operating conditions.
2
Visual check of piping (STP, dispenser and transition) containment sumps f\ I{_
indicates normal function and no indication of water or leaked product.
Impressed Current 60 Day Rectifier Check
Months of the Current Year J F M A M J J A s 0 N
Sho'i\' the date the Impressed Current
S'.\'"Stem l\ras inspected to ensure the (\,
c-quipmE-nt is runnine: properly
Amperage reading from impressed Y\ Cl\.
I current rectifier
\ ·oltage reading from impressed current (\CA
rectifier
INSTRUCTIONS
1. The monthly UST system inspections must be conducted by or under the direction of the Primary Class BUST Operator.
2. The Primary Class B UST Operator must alert the UST Owner or Operator of any condition discovered during the monthly visual
inspection that may require follow-up actions.
3. The UST Owner or Operator must maintain a copy of the monthly inspection reports for the most recent 12 months. The records
shall be maintained on-site or off-site at a readily available location.
\-er. 4/14/2016
--
D
D
UST Annual Compliance Inspection
Facility Information
Name:Fast Stop 1108 Certification/Inspection #:57809
Address:2615 E BENGAL BLVD, Cottonwood Heights, UT, 84121 State ID:4001183
Phone Number:Form Completed By:Larry Vasquez Date:01/02/2025
Tank Information
State Tank ID T3 DSL T2 PUL T1 RUL
Facility Tank # or ID (designation used by facility)T3 DSL T2 PUL T1 RUL
Tank Capacity 4691 gal 8086 gal 11550 gal
Product Name (describe in comments if not listed)Diesel Premium Unleaded
Compartment Only (mark only if NOT the entire tank)
Manifolded Tank (mark for true siphon manifold ONLY)
Tank Status*
if Tank Status = TC:IU IU IU
Date in TC (assessment & OPS extension required > 1yr)
Emptied to 1" or less? (release detection required if not)Y N NA Y N NA Y N NA
Date emptied to 1" or less
Tank Release Detection Method*ATG-CSLD ATG-CSLD ATG-CSLD
Tank Corrosion protection*FRP-N/A FRP-N/A FRP-N/A
Tank Wall Type*FRP FRP FRP
Tank receives > 25 gallons at a time?Yes No Yes No Yes No
Spill Bucket? (required where UST receives >25 gallons at a time)Yes No Yes No Yes No
Spill Bucket Size
Spill Bucket Wall Type*
Overfill Protection? (required where UST receives >25 gallons at a time)Yes No Yes No Yes No
Overfill Protection Type*External Overfill
Alarm
External Overfill
Alarm
External Overfill
Alarm
Piping Corrosion protection*Flex-N/A Flex-N/A Flex-N/A
Flexible Connection - Tank*
Flexible Connection - Dispenser*
Piping Wall Type*DW DW DW
Piping Delivery System*Pressure Pressure Pressure
Line Leak Detector Type (required for PR system)*Mechanical Mechanical Mechanical
Piping Release Detection Method*Annual Line Test Annual Line Test Annual Line Test
STP (Turbine Pump) Containment Sump?No No No
STP Containment Sump Wall Type*NA NA NA
UDC (Under-dispenser) Containment Sump?No No No
UDC Containment Sump Wall Type*NA NA NA
Piping Transition Sumps?No No No
Transition Sump Wall Type*NA NA NA
Comments
1/31/25, 3:30 PM UST Annual Compliance
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Inspection Checklist
For each facility, complete the Annual Compliance Inspection Checklist below by answering the questions. If the facility contains more
than 5 tanks or 8 dispensers, additional copies of this form must be completed. Questions are designated as either a mandatory
compliance item(●) or a recommended practice item(®). If an item is identified as mandatory and recommended, further information is
provided in a note following the question. If "No" is the answer for any mandatory compliance item(●) question, an associated entry must
be made in the Return to Compliance Plan with documentation of the date when the issue was brought back into compliance. The State
must approve all compliance plan schedules. If "No" is the answer for a recommended practice item (®), it is strongly suggested that the
deficiency be corrected.
Tank Information
Inspection Item T3 DSL T2 PUL T1 RUL
Fill Equipment
●1 Is there a product tag on the fill riser pipe or are the lids painted in accordance with a
posted product code color chart?
Y Y Y
®2 Does the fill cap have adequate clearance between the cap and the manhole cover?Y Y Y
●3 Does the tank have a drop tube that extends to within 6 inches of the bottom (if no
diffuser is present)?
Y Y Y
Spill & Overfill Protection
●4 Is each UST that receives more that 25 gallons of product at any one time equipped
with spill and overfill prevention?
Y Y Y
●5 Is the spill bucket free of fuel, water or debris?Y Y Y
●6 Is the spill bucket in good condition and free of damage?Y Y Y
®7 Does the drain assembly work?Y Y Y
●8
Is the tank(s) equipped with an overfill device (e.g. overfill alarm, automatic shut-off
device or ball-float valve) and is the device installed according to manufacturer's
specifications to allow proper functionality?
Y Y Y
●9 Is the tank overfill alarm mounted near the fill port where it can be seen or heard by
the delivery person?
Y Y Y
Temporary Closure
●10
If the tank is in temporary closure and contains greater that 1 inch of product, is
approved release detection performed and maintained? NOTE: OPS recommends that
a tank in temporary closure be emptied (contains <= 1 inch of fluids).
NA NA NA
●11 If the tank is in temporary closure, is corrosion protection maintained?NA NA NA
●12
If the tank has been in temporary closure for greater than 3 months, is the vent line
open and has the piping, pumps, manways, and ancillary equipment been capped and
secured?
NA NA NA
Vapor Recovery (if Required)
●13 Are the vapor recovery adaptor and cap present and free of damage?NA NA NA
®14 Does the vapor cap have adequate clearance between the cap and the manhole cover
to enable hook-up?
NA NA NA
®15 Is the vapor cap in good condition with a gasket?NA NA NA
®16 Is the vapor recovery lid painted orange?NA NA NA
Submersible Turbine Pump (STP) Sump
®17 Are the external and/or internal lids easily removed for inspection?Y Y Y
®18 Are the sump lid, gasket and seals present and in good condition?Y Y Y
●19 Is the sump free of fuel, water or debris?Y Y Y
●20 Is the sump free of cracks, holes, bulges, or other defects?Y Y Y
●21 If the system contains secondarily contained piping with release detection consisting
of sump sensors installed in the sump, is the interstice open to the sump?
NA NA NA
●22 Is the sump sensor properly mounted at the bottom of the sump and operating
according to the manufacturer's specifications?
NA NA NA
●23
Are penetration fittings and entry boots intact, secure and free of damage? NOTE: If
the sump was installed prior to 8-1-08 and is not used for interstitial monitoring, this is
a recommended item.
Y Y Y
1/31/25, 3:30 PM UST Annual Compliance
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®24 Are junction boxes sealed and free of corrosion?Y Y Y
●25 Are the STP components, piping and flex connectors free of leaks or seeps?Y Y Y
●26 If no sump is present, are metal components that are in contact with the soil
cathodically protected?
NA NA NA
●27 Are piping and flexible connectors installed according to the manufacturer's
specifications (not kinked or twisted)?
Y Y Y
●28 Did the mechanical and/or electronic line-leak detector pass its annual functionality
test which includes a leak simulated in the line as part of the functionality test?
Y Y Y
®29 Is the mechanical leak detector properly vented? (vent tube not kinked or twisted)Y Y Y
ATG Port
®30 Is the manhole cover in good condition and is there adequate clearance between the
ATG probe cap and the manhole cover?
Y Y Y
®31 Is the cap in good condition and does it seal tightly?Y Y Y
®32 Are the probe wiring hole, electrical junction box and conduit sealed and in good
condition?
Y Y Y
●33 Are the probe, floats, and water/product warning alarms operating according to the
manufacturer's specifications?
Y Y Y
ATG Console
●34 Does the ATG console have power?Y Y Y
●35 Have all ATG leak alarms been properly addressed?Y Y Y
●36 Is the console programmed correctly for the tanks found at the site (e.g. product,
capacity, points, overfill alarm, in-tank test, line-leak detector test, etc.)?
Y Y Y
●37 Is the sump sensor properly mounted at the bottom of the sump?NA NA NA
●38 Are the sensors functioning according to the manufacturer's specifications?Y Y Y
Tank Interstice
●39 Are the interstitial sensors placed correctly in the tanks?NA NA NA
●40 Are the interstitial sensors functioning according to the manufacturer's specifications?NA NA NA
Cathodic Protection
●41 Are all system components that routinely contain product (tanks, lines, and other metal
components) and that are in contact with the soil properly cathodically protected?
NA NA NA
●42 Has your cathodic protection system (galvanic anodes or impressed current) been
tested within 6 months of installation/repair, and every 3 years thereafter?
NA NA NA
●43 Has the impressed current system (rectifier) been inspected for proper operation at
least every 60 days?
NA NA NA
●44
If you have an internally-lined tank without additional cathodic protection, has it passed
and internal inspection within 10 years after installation of the lining and every 5 years
thereafter?
NA NA NA
®45 If the system is equipped with impressed current, there are no damaged, frayed or
exposed wires?
NA NA NA
Vent Piping
®46 Is the vent cap present and is it the correct type?Y Y Y
●47 Is the vent piping of correct height and above obstructions?Y Y Y
●48 Are diesel and gasoline tanks vented with separate piping?Y Y Y
Unattended Fueling
●49 Is one or more clearly identified emergency shutoff devices located not less than 20 ft.
or more than 100 ft. from the dispensing devices, readily accessible to patrons?
Y Y Y
●50 Is a working telephone or other approved, clearly identified means to notify the fire
department provided on the site, and readily accessible to patrons?
Y Y Y
●51
Is a fire extinguisher with a minimum rating of 40-B, a maintenance inspection not
older than 1 year, and located no more than a 30 ft, travel distance from the
dispensing devices, readily accessible to patrons?
Y Y Y
Monthly Inspection
●52 Have all Monthly inspections been performed and documented, and have all
deficiencies noted during the inspections been corrected?
Y Y Y
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3Dispenser Information
Inspection item D1 D2 D3
●53 Is hanging hardware free of visible signs of leakage or damage?Y Y Y
●54 Are all components of hanging hardware of the proper type and size?Y Y Y
●55 If applicable, is fuel product, safety, octane, diesel sulfur, ethanol, signage present and correct?Y Y Y
●56 Is the under-dispenser containment(UDC) sump free of fuel, water or debris?Y Y Y
●57 Is the UDC sump free of cracks, holes, bulges, or other defects?Y Y Y
®58 Are penetration fillings and entry boots intact, secure and free of damage? NOTE: If the sump was installed prior to
8-1-2008 and is not used for interstitial monitoring, this is a recommended item.
Y Y Y
●59 If the system contains secondarily contained piping with release detection consisting of sump sensors installed in
the sump, is the interstice open to the sump?
NA NA NA
●60 Is the sump sensor properly mounted at the bottom of the sump?NA NA NA
●61 Are junction boxes sealed and free of corrosion?Y Y Y
●62 Are meters, piping and flexible connectors free of leaks or seeps?Y Y Y
●63 Are piping and flexible connectors installed according to the manufacturer's specification? (not kinked or twisted)Y Y Y
●64 If no UDC, are any metal piping components in contact with the soil properly cathodically protected?NA NA NA
●65 Are the shear valves operating according to the manufacturer's specifications?Y Y Y
●66 Is at least one fire extinguisher with a minimum rating of 40-B, and a maintenance inspection not older than 1 year,
located within 100 feet of each dispenser and tank fill opening?
Y Y Y
●67 Is an emergency stop button present and operable?Y Y Y
Note:
Operator Certification
By signing below, the operator certifies that the answers above are accurate and based upon performance of associated inspection
activities, and that the facility owner has received a copy of this inspection form.
Contractor Printed Name:Larry Vasquez Contractor Company Name:CGRS, Inc.
Certification Number:
Contractor Signature:
A or B Operator Printed Name:A or B Operator Cert. No.:
A or B Operator Signature:Date:01/02/2025
1/31/25, 3:30 PM UST Annual Compliance
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Automatic Tank Gauge Inspection
ATG 1
ATG 1650
Facility Information
Name:Fast Stop 1108 Certification/Inspection #:57810
Address:2615 E BENGAL BLVD, Cottonwood Heights,
UT, 84121 State ID:4001183
Phone Number:Form Completed By:Larry Vasquez Date:01/02/2025
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):
3.6
Tank Information
Probe and Programing Inspection:
9.Tank # T1 RUL T2 PUL T3
DSL
10.Tank Facility ID T1 RUL T2 PUL T3
DSL
11.Tank # per ATG T1 RUL T2 PUL T3 DSL
12.Product:Unleaded Premium Diesel
13.Tank Volume, gallons 11550 8086 4691
14.Tank Dia/depth, inches 92 92 92
In-Tank Setup Parameters:
15.Thermal coefficient .000700 .000700 .000450
16.ATG Programmed Diameter 92 92 92
17.Number of points on profile 4 4 4
18.Full volume on profile 11550 8086 4691
1/31/25, 3:30 PM ATG
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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
19.After removing the probe from the tank, it has been inspected and any damaged or missing parts
replaced?
Yes Yes Yes
20.Do floats move freely along the stem without binding?Yes Yes Yes
21.Does product level match console value?Yes Yes Yes
22.Does water level match console value?Yes Yes Yes
23.Water warning (inches)(1")2.5 2.5 2.5
24.High water limit (inches)(1.5")2.5 2.5 2.5
25.Does console water alarm trigger at programmed level?Yes Yes Yes
26.Programmed Overfill Limit (90%)90 90 90
27.Does console overfill alarm trigger at programmed level?Yes Yes Yes
28.Programmed High Product Limit (95%)95 95 95
29.Does console high product alarm trigger at programmed level?Yes Yes Yes
30.Low Product (15% of tank volume or 15" whichever is greater)15 15 15
31.Tank test program enabled?Yes Yes Yes
32.Tank Test Method?CSLD CSLD CSLD
33.Tank Test Rate 0.2 0.2 0.2
34.Test duration (hrs)CONT CONT CONT
35.12 months of tank test history present?Yes Yes Yes
Lines:
36.Electronic Line Leak Type NA NA NA
37.Line # and label in ATG (Q1, Unleaded)N/A N/A N/A
38.Line Test Rate N/A N/A N/A
39.12 months of line test history present?NA NA NA
40.Test Result Pass Pass Pass
1/31/25, 3:30 PM ATG
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Leak Detector
Facility Information
Name:Fast Stop 1108 Certification/Inspection #:57807
Address:2615 E BENGAL BLVD, Cottonwood Heights, UT, 84121 State ID:4001183
Phone Number:Form Completed By:Larry Vasquez Date:01/02/2025
Tank Information
Tank #:T1 RUL T2 PUL T3 DSL
Capacity:11550 8086 4691
Product:Unleaded Premium Diesel
Line #:RUL PUL DSL
Line Type:Pressure Pressure Pressure
LD Brand:Red Jacket Red Jacket Red Jacket
LD Model:FX1V FX1V FX1V
Serial #:0 0 0
Associated Tank:T1 RUL T2 PUL T3 DSL
Resiliency (ml):200 200 80
Check Valve Holding PSI:29 25 12
Opening Time:2 2 16
Result:Pass Pass Pass
Test Equip. Mfg.: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 1108 Certification/Inspection #:57806
Address:2615 E BENGAL BLVD State ID:4001183
Phone Number:Form Completed By:Larry Vasquez Date:01/02/2025
Tank Test Information
Tank #:T1 RUL T2 PUL T3 DSL
Capacity:11550 8086 4691
Product:Unleaded Premium Diesel
Line Test Information
Line #:RUL PUL DSL
LineType:Pressure Pressure Pressure
Line Material:DW Flex DW Flex DW Flex
Line ID Size (in):2 2 2
Line Length (ft):200 200 200
Pump Type:Red Jacket Red Jacket Red Jacket
Associated Tank:T1 RUL T2 PUL T3 DSL
Test Equip. Mfg.:Triangle Triangle Triangle
Test Pressure (PSI):50 50 50
Initial Cyl. Level:450 350 290
Final Cyl. Level:420 310 260
Change in Time (mins):15 15 15
Change in Vol:-30.0000 -40.0000 -30.0000
Change in Temp (F):0 0 0
Coeff. Of Thermal Expansion (g/F):0.00070 0.00070 0.00045
Line Vol (gal):32.62 32.62 32.62
Leak Rate (GPH):-0.0317 -0.0423 -0.0317
Result: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.
Contractor Printed Name:Larry Vasquez Contractor Signature:
Certification Number:TMI-301
1/31/25, 3:30 PM Line Test
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