HomeMy WebLinkAboutDERR-2025-003292State Use Only
Permit Required?
Permit# _____________________
Base Fee $ __500
Inspection Fee* $200 x ___ $_ ___
PST Install Fee $200 x ___ $_ ___
Total $_____
Date Approved & Paid ___________
*Applies in non-LHD contract areas
Utah DEQ Underground Storage Tank
Installation Notification Form
www.undergroundtanks.utah.gov
Facility ID 0100308
New UST Install
Upgrade/Repair
Installation Company:Csesco, Inc.
Contact Name:Tracy Boswell
Phone:(801) 292-4404
Address:830 West Northpointe Circle, North Salt Lake, Utah 84054
Certified Installers/Technicians on project
NameConner Christensen
Cert. # TL 0457
Exp. DateFebruary 1, 2026
NameZane Christensen
Cert. # TL0456
Exp. DateFebruary 1, 2026
NameMitch Hull
Cert. # TL0557
Exp. DateMarch 11, 2026
Tank Owner:Richard L. Miller Enterprises Inc
Address:2455 W Main Street - Tremonton, Utah 84337
Contact Name:Jason Miller
Phone#(435) 257-4570
Facility Name:MIller's Logan
Facility Address:1905 South Hwy. 89-91 - Logan, Utah 84321
Installation / Upgrade /Repair Information
Est. Date work will commence: 4/25/2025
Tank #
1
2
3
4
Capacity
8,000
8,000
8,000
20,000
Tank Material
STIP3
STIP3
STIP3
FRP
Piping Material
FRP SW
FRP SW
FRP SW
FRP DW
Substance stored
Premium
Premium
Diesel
Unleaded
Check if upgradeor repair only.(Describe details below)
Describe Details of Install/Upgrade/Repair in the box below (Submit a drawing/site map of work to be done)
Install (4) new OPW double wall fill spill buckets with (2) straight coaxial drop tubes and (2) straight drop tubes with new fill adapters and caps on the existing Premium, Diesel,
and Unleaded Tanks. Install new vapor recovery adapter on the vapor connection on the Unleaded Tank. Add Veeder Root remote overfill to the existing TLS350. Test new spill buckets
andremote overfill and submit results.
Mail completed form to:
DEQ/DERR
Box 144840
Salt Lake City, Utah 84114-4840
195 N. 1950 W. 1st Floor
Salt Lake City, Utah
Phone (801) 536-4100
Fax (801) 359-8853
Ver. 8/1/2016