DERR-2025-003728

Tank # / Tank Facility ID / ProductLeak Detection:
UST Monthly Compliance Inspection
Facility Information
Name:Fast Stop 1106 Certification/Inspection #:58578
Address:14 E. 1700 S State ID:3000325
Phone
Number:Form Completed By:Ray Simms Date:01/27/2025
4 RUL
T1 RUL
Unleaded
5 DSL
T3 DSL
Diesel
6b Offroad
DSL
T4 Offroad
Dyed
Diesel
6a PUL
T2 PUL
Premium
Tanks:
1 Is release detection equip. operating w/o alarms or unusual conditions? Y N NA Y N
NA
Y N
NA Y N NA
2 Is tank free of water? Y N NA Y N
NA
Y N
NA Y N NA
3 Primary Tank Release Detection Method Inspected:Interstitial
Monitoring
Interstitial
Monitoring
Interstitial
Monitoring
Interstitial
Monitoring
4 Date of last passing result:01/27/2025 01/27/2025 01/27/2025 01/27/2025
5 Are Inventories reconciled daily and are the variances within the guideline set by the
facility owner? Y N NA Y N
NA
Y N
NA Y N NA
Lines:
6 Are line leak detectors present? Y N NA Y N
NA
Y N
NA Y N NA
7 LD s operating properly (no slow flow)? Y N NA Y N
NA
Y N
NA Y N NA
8 Primary Line Release Detection Method Inspected Sump Sensor
Monitoring
Sump Sensor
Monitoring
Sump Sensor
Monitoring
Sump Sensor
Monitoring
9 Date of last passing result:01/27/2025 01/27/2025 01/27/2025 01/27/2025
Fill/Overfill:
10 Fill caps, adapters, gaskets in good condition? Y N NA Y N
NA
Y N
NA Y N NA
11 Fills properly marked? Y N NA Y N
NA
Y N
NA Y N NA
12 Spill bucket free of liquid/debris? Y N NA Y N
NA
Y N
NA Y N NA
13 Spill bucket free of damage/drain work correctly? Y N NA Y N
NA
Y N
NA Y N NA
14 Does the spill bucket drain assembly work correctly? Y N NA Y N
NA
Y N
NA Y N NA
15 For double wall spill bucket, is the interstitial monitoring equipment functioning, in
good condition and not in alarm? Y N NA Y N
NA
Y N
NA Y N NA
16 Fill cap in place and sealed tightily? Y N NA Y N
NA
Y N
NA Y N NA
17 Overfill drop tube free of obstructions? Y N NA Y N
NA
Y N
NA Y N NA
Vapor:
18 Vapor cap in place and sealed tightly? Y N NA Y N
NA
Y N
NA Y N NA
19 Vapor recovery adapter intact? Y N NA Y N
NA
Y N
NA Y N NA
20 Vapor recovery lids painted orange? Y N NA Y N
NA
Y N
NA Y N NA
21 Is Vapor Bucket free of damage and free of liquid/debris? Y N NA Y N
NA
Y N
NA Y N NA
STP Secondary Containment:
22 Sump containment free of water/fuel/debris? Y N NA Y N
NA
Y N
NA Y N NA
23 STP and piping free of leaks and seeps? Y N NA Y N
NA
Y N
NA Y N NA
24 Sump containment free of damage? Y N NA Y N
NA
Y N
NA Y N NA
25 For DW containment with Brine, are levels correct? Y N NA Y N
NA
Y N
NA Y N NA
26 Sensors located @ lowest point in containment? Y N NA Y N
NA
Y N
NA Y N NA
2/7/25, 12:50 PM Monthly Inspection UST CO
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7Dispensing Equipment:Qty:Facility Notes:
27 UDC free of water/fuel/debris? Y N NA
28 All meters/ piping free from leaks and seeps? Y N NA
29 UDC in good condition & free from damage? Y N NA
30 For DW containment with Brine, are levels correct? Y N NA
31 Sensors located lowest point in UDC? Y N NA
32 Shear valves properly set and secured? Y N NA
33 Nozzles, swivels, hoses and connectors free of
leaks? Y N NA
34 All product and whip hoses in good condition? Y N NA
Cathodic Protection:
35 Rectifier is on? Y N NA
2/7/25, 12:50 PM Monthly Inspection UST CO
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Deficiency Information
Rec Item Item ID Equip ID Description Remedy Date Image
®2 6b Offroad
DSL
Offroad DSL ATG shows water. Stuck tank with Sargel, no reaction. Cleaned
probe, checked for sludge - sludge verified in tank.
Contractor Signature:Date:01/27/2025
Printed Name:Ray Simms Certification Number:21899
2/7/25, 12:50 PM Monthly Inspection UST CO
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Tank Test
Facility Information
Name:Fast Stop 1106 Certification/Inspection #:58577
Address:14 E. 1700 S State ID:3000325
Phone Number:Form Completed By:Ray Simms Date:01/27/2025
Tank Information
Tank #4 RUL 5 DSL 6a PUL 6b Offroad DSL
Tank Facility ID:T1 RUL T3 DSL T2 PUL T4 Offroad
Nominal Capacity:11608 11608 6118 6000
Product:Unleaded Diesel Premium Dyed Diesel
Tank Type:UST UST UST UST
Tank Material:DW FRP DW FRP DW FRP
Tank Mfg.:
Multi-Compartment:
Product SG:0.75 0.85 0.75 0.85
Product Vol (gal):5216 3071 2761 1534
Product Level (in):41.69 28.32 42.39 27.86
Water Level in Tank (in):0 0 0 1.13
Grade to tank bottom (in):138 138 138 135
Grade to ground water (in):40 40 40 40
Water on Tank (in):98 98 98 95
Water Determined by:Unable to
determine
Unable to
determine
Unable to
determine
Unable to
determine
Tank Bottom Pressure (inches water):-66.73 -73.93 -66.21 -71.32
Tank % Full 44.9%26.5%45.1%25.6%
TESTING RESULTS
Test Method Type:Vacuum Vacuum Vacuum Vacuum
Test Equip. Mfg., if applicable:Triangle 5000 Triangle 5000 Triangle 5000 Triangle 5000
Min Level (in. WC):-38.73 -45.93 -38.21 -43.32
Start Level (in. WC):-40 -48 -40 -44
End Level (in. WC):-40 -48 -40 -44
Change in Time (mins):30 30 30 30
Gauge Result:Pass Pass Pass Pass
Water Result:NT NT NT NT
Test System Result:Pass Pass Pass Pass
2/7/25, 12:50 PM Tank Test
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Notes
TIGHTNESS TESTING CERTIFICATION
CGRS certifies that the systems in the above table have been tested utilizing leak detection methods which meet the prescribed leak rate testing
standard of 0.10 gph with a minimum probability of detection of 95% and a 5% probability of a false alarm.
CGRS further certifies that the protocol for each test method was strictly adhered to, and that all precision tightness testing performed by CGRS was
conducted in accordance with EPA 40 CFR parts 280.43(c) and 280.44(b) and the National Fire Protection Association, Bulletin NFPA 329 criteria.”
Contractor Printed Name:Ray Simms Contractor Signature:
Certification Number:
2/7/25, 12:50 PM Tank Test
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