DERR-2024-005529

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UST Operator Inspection - Utah
YEAR 2023
Facility Name: RMP Utah Transportation Building Facility ID: 4001061
Address: 3133 West 900 South, Salt Lake City, Utah 84104 Primary Class B Operator: Taber DeHart
NAME(S) AND INITIALS OF PERSON(S) CONDUCTING MONTHLY INSPECTIONS: Jon Sainsbury (JS), Carl Brewer (CB), Mike Howell (MH),
Taber DeHart (TD), Kyle Sandquist (KS)
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 D
Monthly Inspection – Release Detection

1 Release detection equipment is operating with no alarms or other unusual
operating conditions. Y Y Y Y Y Y Y Y Y Y Y Y
2 Records of release detection (tanks and piping) are reviewed and current. Y Y Y Y Y Y Y Y Y Y Y Y
Monthly Inspection – Spill Prevention Equipment

3 Equipment is undamaged, intact and free from defects. Y Y Y Y Y Y Y Y Y Y Y Y
4 Equipment is free from debris, water, or product. Y Y Y Y Y Y Y Y Y Y Y Y
5 Fill Pipe is unobstructed. Y Y Y Y Y Y Y Y Y Y Y Y
6 Fill cap is un-broken and is securely on the fill pipe. Y Y Y Y Y Y Y Y Y Y Y Y
7 Double walled spill prevention equipment - Interstitial area is free from leaks. Y Y Y Y Y Y Y Y Y Y Y Y
Initials of person performing Inspection. TD TD TD TD TD TD TD TD TD TD TD TD
Annual Inspection – Containment Sumps Date of annual Inspection: 12/12/23

8 Secondary Containment Sumps
(STP, Dispenser and Transition)
Visual Inspection of sump indicates no damage and it is free from debris, water and fuel. Y
The penetration fittings for conduits and piping entering the STP Sumps are intact. Y
9 Double Walled Sumps Interstitial area is free from leaks. NA
10 Hand-held release detection
equipment
Hand-held release detection equipment (bailer, gauge stick, etc.) is serviceable and
operable.
Y
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: 12/28/23
B Operator #OB-459

Comments/Follow up:

Turn over for record of Interstitial Monitoring visual inspections and Impressed Current rectifier checks.

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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 che cks.
Months of the Current Year J F M A M J J A S O N D
1 Visual check of the interstitial space of the double-walled tank indicated no
release or unusual operating conditions. NA NA NA NA NA NA NA NA NA NA NA NA
2 Visual check of piping (STP, dispenser and transition) containment sumps
indicates normal function and no indication of water or leaked product. Y Y Y Y Y Y Y Y Y Y Y Y

Impressed Current 60 Day Rectifier Check
Months of the Current Year J F M A M J J A S O N D
Show the date the Impressed Current
system was inspected to ensure the
equipment is running properly

Amperage reading from impressed
current rectifier
Voltage reading from impressed current
rectifier

INSTRUCTIONS
1. The monthly UST system inspections must be conducted by or under the direction of the Primary Class B UST Operator.
2. The Primary Class B UST Operator must alert the UST Owner or Operator of any condition discov ered 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.

Ver. 4/14/2016

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