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Home My WebLink AboutDERR-2025-001829 SENS-D-GEN-TEP-02-1.1 1 FORM 1.2 PREVENTIVE MAINTENANCE TESTING SITE OVERVIEW SIGN-OFF FORM Site: Dugway Proving Ground Start Date: 03FEB2025 Location: Street: Bldg. 4038, Tucker Street, Dugway Complete Date: 06FEB2025 City, State/Country: Utah/USA Incident #: PM25SE5A2RA1 DoDAAC: SE5A2R BE#: 00000305 POC: Gary Morgan POC Phone No.: Comm: 435-831-2679 DSN: 312-789-2679 Description: PM testing was performed on the systems listed below. Tanks monitored by each system are included and detailed data sheets are attached, to include RPUID numbers in documents and drawings. Tank Farm DSL Tank 5660 and DSL Tank 5661 (ATG: Ronan CTM) (IAS: Scully Multiple Liquid Level Panel). Ditto SSTA UNL Tank 1 and DSL Tank 2 (ATG: Veeder Root TLS-450 Plus). Main SSTA UNL Tank 1 DSL Tank 2 (ATG: Veeder Root TLS-450 Plus). Flight Line Storage Jet-A Tank 1 and Jet-A Tank 2. Tech Certs: Enraf Certified Technician. Veeder Root Certification B41310. ICC# 8761158. MS UST # THB5000. Utah UST Technician TL482. Associated Workorder(s): ATG Verification for Inventory Control Form 3.1.5 for each ATG monitor or probe replaced or installed within past two years collected from site and attached to PM Deliverable. ☐ Yes ☒ N/A ☐ No Section 3.1.5 and Form 3.1.5 for each ATG monitor or probe replaced or installed within past two years provided Attachment (A) Automation Maintenance Program Energy Help Desk Guidance was provided to the site POC. ☒ Yes ☐ No Provide explanation if No. Identified problems & Comments (e.g. required maintenance): English Village SSTA ATG and overfill alarm share power circuit. Organization: Print Name: Signature: Date: Contractor Tyrone Davis 10FEB2025 Site Representative Gary Morgan Site Representative email address: GARY.A.MORGAN14.CIV@ARMY.MIL On-site expended time (minutes): 960 MINS **Site representative signature acknowledges responsibility for input of ServiceNow/Helpdesk tickets for the corrective action(s) listed above. Site shall contact their Service Control Point (SCP) for any assistance needed. SENS-D-GEN-TEP-02-1.1 28 FORM 3.1.6.1 Validation of NIST Certified Working Tape Site: Dugway Proving Ground Incident #: PM25SE5A2RA1 Site NIST Certified Tape serial # Date of NIST certification N/A N/A Visually inspect the site’s certified working tape-and-bob combination for damage which includes kinks, worn snap catch, worn bob eye, worn bob tip, and illegible numbers. After the validation check and the visual inspection, does the tape-and-bob combination meet all the criteria required for continued use in the manual gauging of fuel tanks? If site personnel do not have a NIST-certified working tape-and-bob, annotate as, “N/A” in the ‘Pass/Fail’ block and add comment, accordingly. Pass/Fail Comments N/A Site does not have a NIST certified tape and bob. Validation Check Site Working Tape Certification points from NIST-Traceable Certificate Difference between Certified Tape and Actual (Pass =< 3/16'') Cert. Point Actual 15' N/A N/A 30' N/A N/A 45' N/A N/A 60' N/A N/A 75' N/A N/A 90' N/A N/A 100' N/A N/A Maximum Length of Site’s Certified Tape-and-bob N/A ATG Contractor NIST-Certified Tape serial # Date of NIST certification CS17223 3/12/2019 Organization: Print Name: Signature: Date: Contractor Tyrone Davis 10FEB2025 Site Representative Gary Morgan SENS-D-GEN-TEP-02-1.1 29 FORM 3.1.6.2 Validation of Working Tapes by Comparison with Reference Measurement Site: Dugway Proving Ground Incident #: PM25SE5A2RA1 Site Working Tape serial # Working Tape date of validation Tape 1 5210-00-526 Lufkin 50’ 2/3/2025 Tape 2 Non NIST Ditto Airfield 2/3/2025 Tape 3 N/A N/A Tape 4 N/A N/A Visually inspect the working tape-and-bob combination for damage which includes kinks, worn snap catch, worn bob eye, worn bob tip, and illegible numbers. After the validation check and the visual inspection, does the tape-and-bob combination meet all the criteria required for continued use in the manual gauging of fuel tanks? Validation Check Reading on Working Tape Master Tape Certification points Difference between Working Tape and Master (Pass =< 3/16”) Tape 1 Tape 2 Tape 3 Tape 4 Cert. Point Actual Tape 1 Tape 2 Tape 3 Tape 4 15’ 15’ N/A N/A 15' 15.0012” <3/16” <3/16” N/A N/A 30’ 30’ N/A N/A 30' 30.0008” <3/16” <3/16” N/A N/A 45’ 45’ N/A N/A 45' 45.0012” <3/16” <3/16” N/A N/A N/A N/A N/A N/A 60' 60.0021” N/A N/A N/A N/A N/A N/A N/A N/A 75' 75.0017” N/A N/A N/A N/A N/A N/A N/A N/A 90' 90.0008” N/A N/A N/A N/A N/A N/A N/A N/A 100' 100.0000” N/A N/A N/A N/A Maximum Length of Site’s Working Tape-and-bob 50’ 50’ N/A N/A Serviceable (Pass/Fail) Pass Pass N/A N/A Master Used ☐ Site ☒ Contractor Organization: Print Name: Signature: Date: Contractor Tyrone Davis 10FEB2025 Site Representative Gary Morgan SENS-D-GEN-TEP-02-1.1 41 FORM 3.8.2 IAS Sensor Operational Verification Data Site: Dugway Proving Ground Incident #: PM25SE5A2RA1 Fuel movement could not be performed to activate low level, low-low level, high level or high-high level sensors Site POC Print Name: Gary Morgan Signature: IAS Monitor: Scully ST-15-115-WX6 IAS Location: Tank Farm/Storage Building 5666 Checkout for Tank (Tank 5660) Sensor (High-High) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by filling and draining sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (Tank 5660) Sensor (High) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by filling and draining sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (Tank 5660) Sensor (Low) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by draining and filling sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A SENS-D-GEN-TEP-02-1.1 42 FORM 3.8.2 IAS Sensor Operational Verification Data Site: Dugway Proving Ground Incident #: PM25SE5A2RA1 Fuel movement could not be performed to activate low level, low-low level, high level or high-high level sensors Site POC Print Name: Gary Morgan Signature: IAS Monitor: Scully ST-15-115-WX6 IAS Location: Tank Farm/Storage Building 5666 Checkout for Tank (Tank 5660) Sensor (Low-Low) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by draining and filling sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (Tank 5661) Sensor (High-High) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by filling and draining sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (Tank 5661) Sensor (High) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by filling and draining sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A SENS-D-GEN-TEP-02-1.1 43 FORM 3.8.2 IAS Sensor Operational Verification Data Site: Dugway Proving Ground Incident #: PM25SE5A2RA1 Fuel movement could not be performed to activate low level, low-low level, high level or high-high level sensors Site POC Print Name: Gary Morgan Signature: IAS Monitor: Scully ST-15-115-WX6 IAS Location: Tank Farm/Storage Building 5666 Checkout for Tank (5661) Sensor (Low) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by draining and filling sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (5661) Sensor (Low-Low) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. Pass Site unable to move fuel to test. 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. Pass Sensor manually tested by draining and filling sensor chamber. 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. Pass N/A 4 Record activation setpoint. (Gallons or Level) N/A Checkout for Tank (N/A) Sensor (N/A) Item Inspection/Test Description Pass/ Fail Comments/Test Method 1 Activate switch and note audible and visual alarm notification at IAS monitor panel and/or local alarm panel. Verify proper operation of pump and/or valve controllers. N/A N/A 2 If applicable, press Reset at IAS monitor panel and/or local alarm panel and confirm that audible alarm turns off, but visual alarm remains activated. N/A N/A 3 Restore sensor switch and confirm that alarm indications return to normal on IAS monitor and/or the local alarm panel. Pump and/or valve controllers return to normal mode. N/A N/A 4 Record activation setpoint. (Gallons or Level) N/A