DERR-2025-002118

STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UT 84141-1152
[phone]
GAS STATION INSPECTION REPORT
Facility ID#
Facility Name and Site Address: Date:
Purpose:Regular______Reinspection_____Complaints______Annual Inspection ______
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Pumps tested for calibration
Water tests/Fuel storage
Storage tanks properly labeled
Fill caps and underground storage covers-good
Fuel filters on pumps
Overfill prevention valve
Security seals intact
MOTOR FUEL PRODUCTS USED FOR INSPECTION
Regular_____ gallons Unleaded Regular_____ gallons Unleaded Plus_____ gallons
Unleaded Premium_____ gallons Diesel_____ gallons
Product was returned to fuel storage tanks.
Inspection Remarks:
Received by:Inspected by:Steven B. Martin UT0121
Applied Environmental Services L.C.
ACTION TAKEN
BLANDING BUS YARD
458 NORTH 100 EAST
BLANDING, UTAH
2-27-2025
5000310
INSTALLED NEW PV VALVE ON UNLEADED VENT
Dispenser Continuity Test

BILLING ADDRESS FACILITY ADDRESS
WORK ORDER # DATE:
CONTACT: DEQ ID#
APPLIED ENVIRONMENTAL SERVICES, L.C.
SEND PAYMENT TO : APPLIED ENVIRONMENTAL SERVICES
ALL TESTS WERE PERFORMED IN A PROFESSIONAL MANNER, AND WITHIN COMMON PRACTICES OF THE INDUSTRY.
DUE TO VARIABLES OF TIGHTNESS TESTING, THESE RESULTS CANNOT BE GUARANTEED. THERE ARE NO WARRANTIES.
EXPRESSED, WRITTEN, OR IMPLIED.
PO BOX 1073 BOUNTIFUL, UTAH 84011
.
PO#
801-540-9258
STATE FUEL NETWORK
PO BOX 141152
SALT LAKE CITY, UTAH 84141-1152
BLANDING BUS YARD
458 NORTH 100 EAST
BLANDING, UTAH
BRETT GURNEY 246107 5000310 / 1168
25013 2-27-2025
INSTALLED NEW STATE SUPPLIED PV VALVE ON UNLEADED VENT
1 @ 70.00 70.00
SITES SAHRE OF TRAVEL
108 MI @ 2.00 216.00
286.00TOTAL DUE: