DERR-2024-005115

WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

PRODUCT PIPING INTEGRITY TESTING
Facility Name: Fast Break Owner: 379 South Corner Store
Address: 379 South 300 West Address: 379 South 300 West
City, State, Zip: Salt Lake City, Utah 84101 City, State, Zip: Salt Lake City, Utah 84101
Facility I.D.#: 4001552 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 2/22/24
This procedure is to test the integrity of product piping. Tests were performed with Petro-Tite line tester.
Tank Number 1 (NE) 2 (SW) 2a 3 (NW) 1b 4 (SE) 2b
Product Stored RUL MUL PUL DSL
Piping Run Only Out Only Out
Piping Type FRP of FRP of
Test Pressure (PSI) 50 Service 50 Service
Test Duration (minutes) 30 30
Leak Rate (GPH) 0.004 0.004
Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail
Comments: T2 – MUL – is out of service
Tester’s Name Taber DeHart, UT-0394 Tester’s Signature

MU
L
PU
L
DS
L
RU
L
WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

MECHANICAL AND ELECTRONIC LINE LEAK DETECTOR PERFORMANCE TESTS
Facility Name: Fast Break Owner: 379 South Corner Store
Address: 379 South 300 West Address: 379 South 300 West
City, State, Zip: Salt Lake City, Utah 84101 City, State, Zip: Salt Lake City, Utah 84101
Facility I.D.#: 4001552 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 2/22/24
This data sheet can be used to test the mechanical line leak detector (MLLD) and electronic line leak detector (ELLD) with submersible turbine
pump (STP) systems. See PEI/RP 1200 Sections 9.1 and 9.2 for test procedures.
Line Number 1 2 3 4
Product Stored RUL MUL PUL DSL
Leak Detector Manufacturer Red Jacket Red Jacket
Leak Detector Model FX1V FX1V
Type Of leak Detector
☒MLLD
☐ELLD
☐MLLD
☐ELLD
☒MLLD
☐ELLD
☐MLLD
☐ELLD
MLLD (ALL PRESSURE MEASURMENTS ARE MADE IN PSIG)
STP full operating pressure 28 Out 24 Out
Check valve holding pressure 14 Of 16 Of
Line resiliency (ml) (line bleedback volume as measured
from check valve holding pressure to 0 psig) 65 Service 65 Service
Step through time in seconds (time the MLLD hesitates at
metering pressure before going to full operating pressure as
measured from 0 sig with no leak induced on the line)
1 1
Metering pressure (STP pressure when simulated leak rate 3
gph at 10 psig) 10 10
Opening time in seconds (the time the MLLD opens to allow
full pressure after simulated leak is stopped) 1 1
Does the STP pressure remain at or below the metering
pressure for at least 60 seconds when the simulated leak is
induced? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
Does the leak detector reset (trip) when the line pressure is
bled off to zero psig? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
Does STP properly clycle on/off under normal fuel system
operating conditions? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
A "No" answer to any of the above questions indicates that the MLLD fails the test.
ELLD (ALL PRESSURE MEASURMENTS ARE MADE IN PSIG)
STP full operating pressure
How many test cycles are observed before alarm/shutdown
occurs?
Does the simulated leak cause on alarm? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
A "No" answer to the above question indicates that the ELLD fails the test.
Does the simulated leak cause an STP shutdown? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail
Comments:
Tester’s Name Taber DeHart, UT-0394 Tester’s Signature
WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

AUTOMATIC TANK GAUGE OPERATION INSPECTION
Facility Name: Fast Break Owner: 379 South Corner Store
Address: 379 South 300 West Address: 379 South 300 West
City, State, Zip: Salt Lake City, Utah 84101 City, State, Zip: Salt Lake City, Utah 84101
Facility I.D.#: 4001552 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 2/22/24
This procedure is to determine whether the automatic tank gauge (ATG) is operating properly. See PEI/RP1200 Section 8.2 for the inspection
procedure. This procedure is applicable to tank monitor stems the touch the bottom of the tank when in place.
Tank Number 1 2 3 4
Product Stored RUL MUL PUL DSL
ATG Brand and Model TLS 350 Out TLS 350 Out
1. Tank Volume, gallons 8,272 Of 5,264 Of
2. Tank Diameter, inches 96 Service 96 Service
3. After removing the ATG from the tank, it has been
inspected and any damaged or missing parts replaced? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
4. Float moves freely on the stem without binding? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
5. Fuel float level agree with the value programmed
into the console? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
6. Water float level agree with the value programmed
into the console? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
7. Inch level from the bottom of the stem when 90%
alarm is triggered? 80 7/8 80 7/8
8. Inch level at which the overfill alarm activates
corresponds with the value programmed in the
gauge?
☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
9. Inch level from the bottom when the water float
first triggers an alarm? 1.5 1.5
10. Inch level at which the water float alarm activates
corresponds with the value programmed in the
gauge?
☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
If any answers in Lines 3, 4, 5, or 6 are "No" the system has failed the test.
Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail
Comments:
Tester’s Name Taber DeHart, UT-0394 Tester’s Signature

WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

SPILL BUCKET INTEGRITY TESTING HYDROSTATIC TEST METHOD
SINGLE- AND DOUBLE-WALLED VACUUM TEST METHOD
Facility Name: Fast Break Owner: 379 South Corner Store
Address: 379 South 300 West Address: 379 South 300 West
City, State, Zip: Salt Lake City, Utah 84101 City, State, Zip: Salt Lake City, Utah 84101
Facility I.D.#: 4001552 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 2/22/24
This procedure is to test the leak integrity of single- and double-walled spill buckets. See PEI/RP1200 Section 6.2 for hydrostatic test
method, Section 6.3 for single-walled vacuum test method and Section 6.4 for double-walled vacuum test method.
Tank Number 1 2 3 4
Product Stored RUL MUL PUL DSL
Spill Bucket
Capacity 5-Gallon Out of 5-Gallon Out of
Manufacturer OPW Service OPW Service
Construction ☒Double-walled
☐Single-walled
☐Double-walled
☐Single-walled
☒Double-walled
☐Single-walled
☐Double-walled
☐Single-walled
Test Type
☐Hydrostatic
☒Vacuum
☒Double-walled
☐Single-walled
☐Hydrostatic
☐Vacuum
☐Double-walled
☐Single-walled
☐Hydrostatic
☒Vacuum
☒Double-walled
☐Single-walled
☐Hydrostatic
☐Vacuum
☐Double-walled
☐Single-walled
Spill Bucket Type ☒Product
☐Vapor
☐Product
☐Vapor
☒Product
☐Vapor
☐Product
☐Vapor
Liquid and debris remove from spill
bucket?* ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
Visual Inspection (no cracks, loose
parts or separation of the bucket from
the fill pipe.)
☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
Tank Riser cap included in test? ☐Yes ☐No
☒NA
☐Yes ☐No
☐NA
☐Yes ☐No
☒NA
☐Yes ☐No
☐NA
Drain valve included in test? ☐Yes ☐No
☒NA
☐Yes ☐No
☐NA
☐Yes ☐No
☒NA
☐Yes ☐No
☐NA
Starting Level 15” 15”
Test Start Time 10:58 11:04
Ending Level 14” 13.5”
Test End Time 11:03 11:09
Test Period 5-Minute 5-Minute
Level Change -1” -1.5”
Pass/fail criteria: Must pass visual inspection. Hydrostatic: Water level drop of less than 1/8 inch; Vacuum single-walled only: Maintain at least 26 inches water
column; Vacuum double-walled: maintain at least 12 inches water column.
Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail
Comments:
*All liquids and debris must be disposed of properly
Tester’s Name Taber DeHart, UT-0394 Tester’s Signature

WESTECH EQUIPMENT
195 WEST 3900 SOUTH • P.O. BOX 57307 • SALT LAKE CITY, UTAH 84157-0307
801-266-2545 • TOLL FREE 800-433-8831 • 24 HOUR FAX [phone]

UST OVERFILL EQUIPMENT INSPECTION
AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE
Facility Name: Fast Break Owner: 379 South Corner Store
Address: 379 South 300 West Address: 379 South 300 West
City, State, Zip: Salt Lake City, Utah 84101 City, State, Zip: Salt Lake City, Utah 84101
Facility I.D.#: 4001552 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 2/22/24
This data sheet is for inspecting automatic shutoff devices and ball float valve. See PEI/RP1200 Section 7 for inspection pro cedures.
Product Grade RUL MUL PUL DSL
Tank Number 1 2 3 4
Tank Volume, gallons 8,272 Out 5,264 Out
Tank Diameter, inches 96 of 96 of
Overfill Prevention Device Brand OPW Service OPW Service
Type ☒ Automatic
Shutoff Device☐
Ball Float
Valve
☐ Automatic
Shutoff Device
☐ Ball Float
Valve
☒ Automatic
Shutoff Device
☐ Ball Float
Valve
☐ Automatic
Shutoff Device
☐ Ball Float
Valve
AUTOMATIC SHUTOFF DEVICE INSPECTION
1. Drop tube removed from tank? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
2. Drop tube and float mechanisms free of debris? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
3. Float moves freely without binding and poppet moves
into flow path? ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
4. Bypass valve in the drop tube open and free of
blockage (if present)?
☒Yes ☐No
☐Not Present
☐Yes ☐No
☐Not Present
☒Yes ☐No
☐Not Present
☐Yes ☐No
☐Not Present
5. Flapper adjusted to shut off flow at 95% capacity? * ☒Yes ☐No ☐Yes ☐No ☒Yes ☐No ☐Yes ☐No
A "No" to any item in Lines 1-5 indicates a test failure.
BALL FLOAT VALVE INSPECTION**
1. Tank top fitting vapor-tight and leak free? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
2. Ball float cage free of debris? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
3. Ball free of holes and cracks and moves freely in cage? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
4. Vent hole in pipe open and near top of tank? ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
5. Ball float pipe proper length to restrict flow to 90%
capacity? *** ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No ☐Yes ☐No
A "No" to any item in Lines 1-5 indicates a test failure.
Test Results ☒Pass ☐Fail ☐Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail
Comments:
*Use manufacturer’s suggested procedure for determining if automatic shutoff device will shut off flow at 95% capacity.
**If a ball float valve is found to fail the inspection, another method of overfill must be used.
***Use manufacturer’s suggested procedure for determining if flow restriction device will restrict flow at 90% capacity.
Tester’s Name Taber DeHart, UT-0394 Tester’s Signature

Overfill Prevention Equipment Inspection
OPW 61 and 71 Series Overfill Prevention Device Inspection (Non Testable)
Customer Name:
Facility ID #:
Address:
Street
Date:
City, State
Tank Designation RUL PUL
Part 1 - Proper Height Setting Calculation YES NO
OPW Installation Manual H15524PA Rev L 1/30/2014)
Maximum Tank Volume (Gallons) Shown on customers provided tank chart Gallons 8,272 5,264
Max Shut off requirement for flapper is 95% %95%95%
Multiply maximum tank volume by 95% (Gallons)95%Gallons 7,858 5,001
Find the dip stick number on the tank chart that corresponds with 95%X Inches 86.625''86.625''
Measure top of fill riser threads, or face seal adapter A Inches 32.750''33.750''
Find the Dip Stick Volume that corresponds with 100% (FROM TANK CHART)Y Inches 96.000''96.000''
Upper Tube in tank (Y) -(X) = (Z)Z Inches 9.375''9.375''
Subtract 2 inches from upper tube in tank Formula: (Z) - 2" = (C )C Inches 7.375''7.375''
Calculated minimum upper tube length Formula: (C ) + (A) = Upper Tube Length Calculated Inches 40.125''41.125''
Actual measured upper tube length (without fill adapter)Actual Inches 40.875''41.750''
Part 2 - Device Certification Citeria Evaluation
Criteria 1 Does the overfill prevention device meet the 95% requirement?YES YES
(If Actual is greater than or equal to calculated ( YES)
(If Actual is less than or equal to calculated ( NO)
Criteria 2 Is the actual measured upper tube length 6.5 inches or more than the fill riser?YES YES
(C must be 6.5" if not then the upper tube length is 6.5 plus measurement A)
(For testable models ending in "T" upper tube length is (C)+ (A) - 1 -1/2". If less than 6.5" than
it is 6.5" +(A) - 1-1/2")
Criteria 3 Does the overfill prevention device function function as required?YES YES
(Inspect the device for damage, contamination, freedom of
movement, weakening due to wear and corrosion)
Part 3 - Device Certification PASS / FAIL PASS PASS
Technician certifies that the device is operationally compliant.
If the response to Criteria 1, 2, and 3 above are YES.
Date:
Fast Break
4001552
379 Soth 300 West
Salt Lake City, Utah 841012/22/2024
OPW 71SO-410C Overfill Drop
Tube Make
and Model
Tank
Chart
Comments:
2/22/2024
Signature of
Technician:
Tank Chart
Provided by