DERR-2025-003290

Page l ofヱ Utah Department of Environmental Quality
UST Release Detection lnspection
0100590
Ownership ol Tanks Location of Tanks
PILOT TRAVEL CENTERS tLC FLYING J TRAVEL PLAZA ■748
PO 80X10146 600 VV 750 N
KNOXVILLE ITN 137909 W LLARD lUT 34●40
OP A Chares Hughes l(365)2065269 OP B:STEPHEN THOMAS HAMPTON I(614)923‐0154
V.rityi..t ootrntd.t .h.€l
.n cur.nt.nd o. fh.① No NA Single walled Spill buckets:① No NA
、γらノ No NA aYet No NA
Lim taghtnes(sucliq 3tr):Yes No L Yes No @
Yes No NA
d@ No NA
ompl.l.lor.ach tant.″#23|#Capacily ol lank (gallons):ヽ2o゛ 2-
飩 _、_ぃ ヽ、こハ
Dale lasl used7depth oi producl:
Type of spill p.evention device:Sい Sら
`じ
S3 ヽOS,
Double Waled spl bucket 9auge is
checked mOnthly and vald:v." r,ro @ Yes No @ Yes No @ Ves No NA Yes No NA
Spillbuckel E clean, inracl, etc.O No ぐ
`蓼
ン N。
Type ol overlill Prevenl on devi@ へヽ
^“
へ‐
Ove.fillahm (audrble or vrsible)is propert tealed so detrvery d.ive. €n hearorse il, and is cl6a.ly identifred Yes No @\
STP F ex proleclon meu10d(sump
Cat卜 odic P,。teclion lsolaled BoOted)■、__,ヽ_a*-?
Cont inrenl slmps dry:Ves Cコ
' NA
Ves OS｀ NA Yes @ NA Yes No NA Yes No NA Yes No NA
_■ビ三Jい
'
【tr
Stago 1 Vapor Reovery:@co", tlon"@)coax None 2pt cOaxメ おnヽ
Pressure Venl Valve is on vents 、∈,, No NA ―No NA Yes No @ Yes No NA Yes No NA Ves No NA
Compl.r. tor .a.h di3pen$.
"
ヽ′″ ヽ/●'/ι
摯 7/3 ″■/′0.l l/z
Flex protectOn method(UDC
Cathodic Protect on ls。lalod Booted)ぃ0し ЦOし Чに ЦOこ Чoこ ●●`ぐ璽E> No NA O No NA aC澤 2 No NA ′Vo No NA @, No NA に っ No NA
Dw pipins havejlmpels in ptael Yes No 叫 Yes No NA くL`:ユ No ψ ves tlo 1&,Yes No @
Fre valve anchorcd. Iocstod bet
grade, and eittlout batt vatve:
O No NA CNo NA こ==>No NA @s2 No NA ♪ No NA o No NA
Additlona I disp!nser questiohs # 1'―′ャ_`5.1`nl′く ″ヽ■‐2ヽ#,Flex protecl@n melhod (UOC,
calhodc P@reclron, lsolated. Boole!)l ヽよ u●r疇
Yes No @ CB No NA Yes No @,)Yes No NA Yes No NA
Dw pipins have jumpels tn ptacel Yos No @ Yes No @ Yes No 6,Yes No NA Yes N。NA
Fife va ve anchored, ocated below
grade and no bal valve:
｀こ鮨′ No NA ″ヽs'No NA aB, No NA Yes No NA Yes No NA Ves No NA
lmp.o34d Curent Cathodtc Protectton Last thra dales rectifier checked:
Flnancial Responsib∥ity(state use only)
′ら｀No FR Method: lMe$odox? I yes No by:
cos2 No
'C'Op€EtoE ran€dorunmann.d s& sign rs vsible?
、ヽヽ.L r.I`′ inspected lh s facl,。n｀32・ 2`lf the siie is unman.ed and dispenses tuet, does ii have
an emorgenc-y shutofi devi@?O No NA
“
ゑ TI
Oι ヽこMonthly checklist availabto and compteie?く:yり Noi`
Page 2●f」2Tank and
Automatic Tank
Piping Release Detection
Gauging/lnterstitial Monitoring
0100590
Ta.k. in3t llod an r O.tobo. 1 , 20Og mu.t do lnte6titial foniio.i.g,
t I .2 gpn monthty lesl Type oflM? ATG o. Manual
l,lsR
[ ! ATG conlinuous test[ ] ATG Shutd@n tesl
l{anul.ctorcrand odelof sy.r.m:
Circlo Y6s d No ld oach qu6tion. ln tfi€ hsl cotumn, sxptain and idsnrity by iank any.x@prions to lhs ans*er6 givsn in ho fr6i 6lumn.
Ty,p€ oi lM deumenlalion used: ATG ManualTyp€ of sndary @ntaanmont us€d:
ststem rs capable ofdetoctrng a r6l6as6 ol r6gulal6d subslanes from any
ponion of the primary tankpipinq wilhin one month ofrelease:
ATG @n$le or orher oquipmont us6d to iak6 Eadmgs and porlom l6sts is
adoquats, accsssible, and opeEiional:
ヽ id P,●Mh[。●●イЮm a●1U●t●,h●●|。,AiG Shuお o輛 (“|Thotankwasfillod to at l6asl lhe minimum l€velrequnod b onsuro a valid l6ak
lest, and th€ tank size is wilhin ih€ allovr'od lppor and lowor sizo limits:
reBult3 ol monitoring lor .ach tan* lor the last 1 2 monlhs. lndical. PaE3, Fail, lnvalid, or No Results for each Eonth. For ATG Shutdown t6t3,
tho highGt product l.vel t.sr.d for.ach month.
lndicale lhe melhod used:
P€ssunzed pipng must have an Aulomalic Lin6 Loak Oelector and one other
Suctin piping musl be teslod ev6.y 3 yoa.s o. have monlhly monitmng ll saie suclion, leak deleclion is delered.
PIpln! ln.t lLd.tio, ocrobor 1,2008,nusl do lntsr.llll.l Monhorlng-
I Line Tighh6ss Testlng
10′,2018
I lot66titial llbnitodng