DERR-2024-005437

OVERFILL OPERABILITY
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 3/26/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 3/19/2024
Order Number: 2368831
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
SAM'S CLUB # 6684 (SC6684)
4949 S 900 W
RIVERDALE, UT 84405
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
SAM'S CLUB # 6684
4949 S 900 W
RIVERDALE , UT 84405
SC6684
Tanknology, Inc.
WALMART/SAM'S CLUB
479-360-2779
800-800-4633 03/19/2024
RUL
1
19703
117.75
OPW
UT151
David Mathie
DEPT. 9641
BENTONVILLE, AR 72716
55
161
19703
104
19703
18543
94.1
Site ID/ Name:
Address:
SC6684 SAM'S CLUB # 6684 NW1-2368831 03/19/2024
4949 S 900 W , RIVERDALE, UT 84405
Tank ID:REGUNLD(UNLEADED)
Tank ID:
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2368831
Site ID / Name:SC6684 / SAM'S CLUB # 6684
Address:4949 S 900 W
City:RIVERDALE State:UT Zip:84405