DERR-2024-005714

PST Owner Information
Facility ID#
PST Facility Information
Owner Name: Facility Name:
Address: Address:
City: State: Zip: City: State: UT Zip:
Contact: Phone: Contact: Phone:
DESCRIPTION OF PETROLEUM STORAGE TANKS
Tank #
UST or AST
Date Installed
Capacity
Substance Stored
TANK/LINE TIGHTNESS TEST Indicate Pass or Fail for each tank and product line tested. Include a copy of the test.
Tank #
Tank Test
Line Test
TYPE OF FACILITY
Marketing facility, or non-marketer with facility average monthly throughput greater than 10,000 gallons.
Non-marketer with facility average monthly throughput less than 10,000 gallons.
COMPLIANCE WITH PST REGULATIONS
All Petroleum Storage Tanks (PSTs) at this facility have been registered.
Registration fees and Petroleum Storage Tank Fund Fees have been paid.
Are your PSTs currently in compliance with all Federal, State, and Local PST regulations, including applicable Fire Code?
Yes No If "No" describe items of non-compliance:
PREVIOUS POLLUTION INCIDENTS
Complete the Previous Pollution Incidents form to indicate whether a pollution incident has occurred at the facility.
FINANCIAL RESPONSIBILITY MECHANISM DECLARATION (check one only)
* Non-regulated PSTs at the facility may be required to participate in the Environmental Assurance Program.
I choose another Financial Responsibility mechanism for the PSTs at this facility.
•Indicate the financial responsibility mechanism to be used:
•(For self-insurance or guarantee) Indicate your company’s fiscal year end date:
•(For Insurance) Indicate the date the policy is renewed each year:
The Certificate of Compliance cannot be issued until all documents have been submitted and the mechanism has been approved. If
the mechanism has already been approved, submit documentation of coverage for the new tanks.
I certify under penalty of law that the above representations made by me are true and correct.
CofCapp 1022
Utah Petroleum Storage Tank Program
Application for Certificate of Compliance
I choose to participate in the Environmental Assurance Program (PST Fund) *.
•Indicate the financial responsibility mechanism to be used for cleanup costs not covered by the Fund.
•Indicate the number of non-regulated petroleum storage tanks at the facility.
Owner/operator Signature Date Signed
Utah Petroleum Storage Tank Program
Previous Pollution Incidents Facility ID#
This letter, or an equivalent, must be signed and submitted as a requirement for receiving a
Certificate of Compliance.
To: Mr. Brent H. Everett
Director
Division of Environmental Response and Remediation
Dear Mr. Everett:
As required by paragraph 19-6-413 of the Utah Underground Storage Tank Act, I have performed
a tank and line tightness test on each tank at my facility. Based on this test, there has not been a
release of petroleum. Additionally, based on "customary business inventory practices standards" I
am not aware of any release of petroleum from my tanks.
Signature of owner/operator
Or, if a release is known to have occurred at this facility:
I have had the following releases of petroleum (detailed below; also indicate the actions you have
taken to clean up the release):
Signature of owner/operator
Failure to report previous releases could invalidate your Certificate of Compliance.
ppiform 1022
STEPHANIE SHELDON
WALMART PAYSON
1052 S TURF FARM RD
PAYSON, UT 84651
Dear STEPHANIE SHELDON:
We are pleased to inform you that you have successfully passed the Utah Division of Environmental Response and
Remediation (DERR) Underground Storage Tank (UST) Operator Training examination.
Following the passing of this exam we have issued you the following A/B Operator Registration Number(s).
License No License Expires
OA - 2104 02/05/2027
OB - 2281 02/05/2027
According to the information supplied on your application, you are responsible, as a class A or B operator, for the
following facilities:
Class A:
Facility ID#Facility Name Primary
1000997 WALMART SUPERCENTER FUELING STATION #5167 Yes
Class B:
You will be required to be re-trained if any of the above listed facilities are found to be out of compliance under
Utah Administrative Code, Subsection R311-201-12(k).
Your registration will be effective for three (3) years. You may apply for registration renewal not more than six (6)
months prior to the expiration date of your registration.
If you have any questions about the exam or the registration program, please contact Chelsea Qualls at [phone]
or [e-mail].
State of Utah
SPENCER J. COX
Governor
DEIDRE HENDERSON
Lieutenant Governor
Department of
Environmental Quality
Kimberly D. Shelley
Executive Director
DIVISION OF ENVIRONMENTAL
RESPONSE AND REMEDIATION
Brent H. Everett
Director
February 22, 2024
Testing and Inspection Certificate
Tanknology Inc.
11000 North MoPac Expressway, Suite 500, Austin, TX 78759
800-800-4633 www.tanknology.com Page 1 of 1

Test Date 2/22/2024 Tanknology WO#NW1-2364467
Test Purpose POST CONST Customer PO#38431855

Customer Location

SAM'S CLUB
2001 S.E. 10TH STREET
DEPT. # 449562
BENTONVILLE, AR 72716

WALMART #WM5167
964 TURF FARM RD
PAYSON, UT 84651

Attn: PROJECT MANAGER Attn: Asset Protection Manager
[phone]
()

Test / Inspection Description Item Tested Date
Tested Result
PEI RP 1200 Sump Testing See test report for details 2/22/2024 Pass

PEI RP 1200 Sump Testing See test report for details 2/22/2024 Pass

Line Interstitial 1 2/22/2024 P
Line Interstitial 2 2/22/2024 P
Line Interstitial 3 2/22/2024 P
Line Interstitial 4 2/22/2024 P
Turbine Sump Test 1 2/22/2024 P
Turbine Sump Test 2 2/22/2024 P
Turbine Sump Test 3 2/22/2024 P
Turbine Sump Test 4 2/22/2024 P

Tanknology Representative: David Edens Technician: David Mathie
Telephone: ()Technician Certification: (See forms)
WALMART #WM5167
964 TURF FARM RD
PAYSON UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE AR 72716
479-204-3407
02/22/2024
FRP
50
26
30
933
30
1033
1
0
FRP
49
26
30
933
30
1033
1
0
FRP
48
26
30
933
30
1033
1
0
FRP
50
26
30
933
30
1033
1
0
Tank 1 STP Sump
1
Tank 2 STP Sump
1
Tank 3 STP Sump
1
Tank 4 STP Sump
1
UT151
David Mathie
NW1-2364467
WALMART #WM5167
964 TURF FARM RD
PAYSON UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE AR 72716
479-204-3407
02/22/2024
POLY
16.5
7
13
910
13
1010
1
0
POLY
16.5
7
13
910
13
1010
1
0
POLY
16
7
13
910
13
1010
1
0
POLY
16.5
7
12
910
12
1010
1
0
POLY
16
7
13
910
13
1010
1
0
1/2 3/4 5/6 7/8 9/10 11/12
POLY
16
7
13
910
13
1010
1
0
UT151
David Mathie
NW1-2364467
WALMART #WM5167
964 TURF FARM RD
PAYSON UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE AR 72716
479-204-3407
02/22/2024
POLY
16
7
13
910
13
1010
1
0
POLY
16
7
13
910
13
1010
1
0
13/14 15/16
UT151
David Mathie
NW1-2364467
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2364467
Site ID / Name:WM5167 / WALMART #WM5167
Address:964 TURF FARM RD
City:PAYSON State:UT Zip:84651
W.O.# NW1-2364467 Cust Ref#: 38431855
ANNULAR C1
W.O.# NW1-2364467 Cust Ref#: 38431855
LINE ANN C2
W.O.# NW1-2364467 Cust Ref#: 38431855
LINE ANN C2
W.O.# NW1-2364467 Cust Ref#: 38431855
OVF
Product Line Tightness Test Page 1 of 1
Work Order: 2364472 Date: 3/26/2024
Site Name/ID: WALMART #WM5167 / WM5167
Address: 964 TURF FARM RD
City: PAYSON State: UT Zip: 84651
Tank Information
Test Method
Customer Tank ID
Product Name
Delivery Type
Test Pressure (psi)
Test Start Time
Test End Time
Final Leak Rate (gph)
Test Result(P/F/I)
Test was performed per
3rd party certifications as
specified in 40 CFR parts
280 and 281
Tank # 1
Line # 1
TLD-1
1
RUL
Pressure
60
08:42
09:42
0.00
Pass
Yes
Tank # 2
Line # 1
TLD-1
2
RUL 2
Pressure
60
08:42
09:42
0.00
Pass
Yes
Tank #
Line #

Tank #
Line #

Tank #
Line #

Tank #
Line #

Technician Comments:
Technician Name:David Mathie Certification #:41442 exp:
10/20/2025
Technician Signature:

Environmental Compliance for Petroleum Systems
©2024 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com
WALMART #WM5167
964 TURF FARM RD
PAYSON UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE AR 72716
479-204-3407
03/26/2024
RUL RUL 2
Veeder Root
DPLLD
Veeder Root
DPLLDDPLLDDPLLD
40
2
40
2
UT151 PREM AND DSL NOT PURGED YET
David Mathie
NW1-2364472
T1:1 T2:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2364472 Date:3/26/2024
Site Name/ID:WALMART #WM5167
Address:964 TURF FARM RD
City:PAYSON State:UT Zip:84651
How Inspected: Line Test NFPA 30A PEI RP1200 Other AND STP ON PREM DSL
Dispenser
Number Grade
Secure
Mount?
Valve
Lock?Pass/ Fail Comments
1/2 40 Pass Fail Not Tested
1/2 85 Pass Fail Not Tested
1/2 91 Pass Fail Not Tested
3/4 85 Pass Fail Not Tested
3/4 91 Pass Fail Not Tested
5/6 85 Pass Fail Not Tested
5/6 91 Pass Fail Not Tested
7/8 40 Pass Fail Not Tested
7/8 85 Pass Fail Not Tested
7/8 91 Pass Fail Not Tested
9/10 40 Pass Fail Not Tested
9/10 85 Pass Fail Not Tested
9/10 91 Pass Fail Not Tested
11/12 85 Pass Fail Not Tested
11/12 91 Pass Fail Not Tested
13/14 85 Pass Fail Not Tested
13/14 91 Pass Fail Not Tested
15/16 40 Pass Fail Not Tested
15/16 85 Pass Fail Not Tested
15/16 91 Pass Fail Not Tested

Technician Comments:
Technician Name:David Mathie
Signature:
Environmental Compliance for Petroleum Systems
©2024 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com
WALMART #WM5167 SAM'S CLUB
964 TURF FARM RD
PAYSON UT 84651
WM5167
Tanknology, Inc.
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE AR 72716
479-204-3407
800-964-1250 03/26/2024
1 2 3 4
RUL RUL2 PREM DSL
VR 450PLUS VR 450PLUS VR 450PLUS VR 450PLUS
19782 19782 11904 7901
118.4 118.4 118.4 118.4
UT151
David Mathie
964 TURF FARM RD
WALMART #WM5167
964 TURF FARM RD, PAYSON, UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE, AR 72716
479-204-3407
03/26/2024
ANNULAR ANNULAR ANNULAR STP STP STP STP
RUL RUL2 PREM/DSL RUL RUL2 PREM DSL
UT151
David Mathie
964 TURF FARM RD
WALMART #WM5167
964 TURF FARM RD, PAYSON, UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE, AR 72716
479-204-3407
03/26/2024
UDC UDC UDC UDC UDC UDC UDC
1/2 3/4 5/6 7/8 9/10 11/12 13/14
UT151
David Mathie
964 TURF FARM RD
WALMART #WM5167
964 TURF FARM RD, PAYSON, UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE, AR 72716
479-204-3407
03/26/2024
UDC
15/16
UT151
David Mathie
WALMART #WM5167
964 TURF FARM RD
PAYSON, UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
479-204-3407
03/26/2024
2001 S.E. 10TH STREET DEPT. # 449562
BENTONVILLE, AR 72716
1
RUL
5
OPW
2
RUL2
5
OPW
3
PREM
5
OPW
4
DSL
5
OPW
15 WC
1008
15 WC
1013
5
0
15 WC
1011
15 WC
1016
5
0
15 WC
1021
15 WC
1026
5
0
15 WC
1030
15 WC
1035
5
0
UT151
David Mathie
2 inch Pressure Decay Test
TP201.3

Store Information Testing Company
Site Name :WALMART #WM5167 Name :TANKNOLOGY INC.
Address :964 TURF FARM RD
PAYSON, UT 84651
Address :11000 N. MoPac Expressway Suite 500
Austin, TX 78759
Phone :-Phone :[phone]

Stage I System?DUAL
Stage II System?NONE
Total # of Nozzles :16
Products per Nozzle :3
Tanks Manifolded ?Yes
Drop-Out tank present?NO
Total # of Tanks Tested :3

Tank Information :
Product Grade :
Tank Capacity, gallons :
Gasoline, gallons :
Ullage, gallons :
Testing Information :
Start Time :
Initial Pressure, wcg :
Pressure @ 1 minute(s) :
Pressure @ 2 minutes :
Pressure @ 3 minutes :
Pressure @ 4 minutes :
Pressure @ 5 minutes :
Allowable Final Pressure :
Pass/Fail (Enter "GF" Gross Failure)
1
RUL
19782
10805
8977

2
RUL 2
19782
11123
8659

3
PREMIUM
11904
8848
3056

09:52
2.00
2.00
2.00
2.00
1.99
1.99
1.95
Pass

Total

51468
30776
20692
All
09:52
2.00
2.00
2.00
2.00
1.99
1.99
1.95
Pass
Comments:

Tester :David Mathie Test Date :3/26/2024
Signature :Work Order :2364472

WO: 2364472
PVVC tested ==>GAS Manifolded
Final Test Result (Pass / Fail) ==>Pass
PVVC Manuf. ==>Husky Model Number ==>5885
Is this Original or
Replacement?
Original
If this cap is being
replaced, check here:
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)0.05 9 0.0191 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.66 Pass
Neg Leak Rate (CFH)0.21 21 0.0445 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -6.84 Pass
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
11000 N. MOPAC EXPRESSWAY, SUITE 500, AUSTIN, TX 78759
[phone]
QP-08-03-FF-02 Pressure Vacuum Vent Cap TP-201.1E Field Form
Rev C 1/27/2011
Site Overall Test Results: Pass
Total +ve LR: 0.0191
Total -ve LR: 0.0445

Test Date 3/26/2024
Technician Name David Mathie
WO #2364472
Facility Name / Loc #WALMART #WM5167 WM5167
Street 964 TURF FARM RD
City, St, Zip PAYSON, UT 84651

Pressure Vacuum Vent Cap Test Form TP-201.1E

Stage I Vapor System Survey
Survey to determine compliance with Requirements of Title 40 Part 63 National Emission Standards for Hazardous Air Pollutants for Source Categories

Survey Date 3/26/2024 Work Order 2364472
Cust Name / Location Number WM5167
Street Address 964 TURF FARM RD
City, State, ZipCode PAYSON UT 84651

Product
Stage I Type
Drop Tubes Type
Drop Tubes Max inches from tank Bottom
Fill Adapters Type
Vapor Adapters Type
NESHAP Work Required?

Vent Caps
Type
Labeled Positive Cracking Pressure
Labeled Negative Cracking Pressure
1
RUL
Dual Point
Straight w/ Flapper
6.00
Swivel
Swivel (poppet)
No

2
RUL 2
Dual Point
Straight w/ Flapper
6.00
Swivel
Swivel (poppet)
Yes

3
PREMIUM
Dual Point
Straight w/ Flapper
6.00
Swivel
Swivel (poppet)
No

GAS
Pressure Vacuum cap
3
8

Describe Work Required

Surveyed by Signature
WALMART #WM5167
964 TURF FARM RD
PAYSON, UT 84651
WM5167
Tanknology, Inc.
SAM'S CLUB
479-204-3407
800-800-4633 03/26/2024
RUL
1
19782
118.375
OPW
RU2
2
19782
118.375
OPW
PREM
3
11904
118.375
OPW
DSL
4
7901
118.375
OPW
UT151
David Mathie
2001 S.E. 10TH STREET
BENTONVILLE, AR 72716
57.25
163.75
19782
104.5
18567
19782
93.8
Site ID/ Name:
Address:
WM5167 WALMART #WM5167 NW1-2364472 03/26/2024
964 TURF FARM RD, PAYSON, UT 84651
Tank ID:1(RUL)
59
165.5
19782
104.5
18567
19782
93.8
Site ID/ Name:
Address:
WM5167 WALMART #WM5167 NW1-2364472 03/26/2024
964 TURF FARM RD, PAYSON, UT 84651
Tank ID:2(RUL 2)
59.5
166
11904
104.5
11208
11904
94.2
Site ID/ Name:
Address:
WM5167 WALMART #WM5167 NW1-2364472 03/26/2024
964 TURF FARM RD, PAYSON, UT 84651
Tank ID:3(PREMIUM)
60
166.25
7901
104.25
7367
7901
93.2
Site ID/ Name:
Address:
WM5167 WALMART #WM5167 NW1-2364472 03/26/2024
964 TURF FARM RD, PAYSON, UT 84651
Tank ID:4(Low Sulfur Diesel)
Tank ID:
Sam's Club Emergency Stop (E-Stop / ESO) Periodic Inspection
Facility Information Technician Information
Site #: WM5167 Date: 3/26/2024
Address: 964 TURF FARM RD Name: David Mathie
City / State: PAYSON UT Technician Signature:
SITE DATA
1 Number of E-Stop switches INSIDE the building: 1
2 Number of E-Stop switches OUTSIDE the building: 2
3 Call Alarm Central at 479-273-4600
a.Press 1 for Alarm Central
b.Then press 4 for Technician
c.Tell the operator you want the Sam's Club / Wal-Mart Gas Station account for club membership WM5167 put on test.
d.They will ask for a password which is: 9350.
e.Record the Alarm Central persons name and the time that you spoke to them(Pre Alarm) LADY 10:48:00
PERFORMANCE DATA Yes No NA
4 You have added or confirmed that all E-Stop locations are on the Site Diagram
5 Do all E-Stops shutdown power to ALL DISPENSERS
6 Do all E-Stops shutdown power to ALL STP's
7 Are ALL E-Stops clearly Labeled
8 Are the TURBINE BREAKERS clearly identified / labeled
POST TEST
9 All equipment secured and any access ports, lids, enclosures are closed.
10 All safety barricades and test equipment has been properly removed
11 E-Stop was reset and all dispensing functions are normal
12 Call Alarm Central at 479-273-4600
a.Ask if Alarm was Received and if Yes, advise that testing is complete
b.Record the Alarm Central persons name and the time that you spoke to them(Post Alarm) ZEK 11:05:00
E-Stop Inspection Results
PASS FAIL INCONCLUSIVE
Comments
NOT CONNECTED YET BUT THEY SEEN 3 ALARMS

WO: 2364472
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2364472
Site ID / Name:WM5167 / WALMART #WM5167
Address:964 TURF FARM RD
City:PAYSON State:UT Zip:84651
W.O.# NW1-2364472 Cust Ref#: 38431855
OVF
W.O.# NW1-2364472 Cust Ref#: 38431855
+AAE-
I10100
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I90200
10/02/23 11:24 PM
SOFTWARE REVISION LEVEL
VERSION 33.54
SOFTWARE+ACM- 342005-010-J-
CREATED - 23.08.07.19.08
+AAMAAQ-
I20100
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC-VOLUME ULLAGE HEIGHT WATER TEMP
1 T1-Unleaded 10801 0 8981 63.37 0.00 56.11
2 T2-Unleaded 11146 0 8636 64.95 0.00 55.08
3 T3-Premium 8429 0 3475 78.07 0.00 54.41
4 T4-Diesel 3559 0 4342 54.46 0.00 55.84
+AAMAAQ-
I20600
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
TANK ALARM HISTORY
TANK 1 T1-Unleaded
SETUP DATA WARNING 03/19/24 2:53 PM
HIGH WATER ALARM 10/02/23 10:28 PM
OVERFILL ALARM 10/02/23 10:53 PM
LOW PRODUCT ALARM 03/19/24 2:53 PM
INVALID FUEL LEVEL 03/21/24 7:20 AM
10/02/23 10:50 PM
10/02/23 10:25 PM
PROBE OUT 03/20/24 9:42 AM
HIGH WATER WARNING 10/02/23 10:28 PM
DELIVERY NEEDED 03/19/24 2:53 PM
10/02/23 10:50 PM
10/02/23 10:25 PM
TANK 2 T2-Unleaded
SETUP DATA WARNING 03/19/24 2:53 PM
HIGH WATER ALARM 10/02/23 10:35 PM
10/02/23 10:27 PM
OVERFILL ALARM 10/02/23 10:36 PM
LOW PRODUCT ALARM 03/19/24 2:54 PM
INVALID FUEL LEVEL 03/21/24 7:20 AM
10/02/23 10:24 PM
PROBE OUT 03/20/24 9:46 AM
HIGH WATER WARNING 10/02/23 10:35 PM
10/02/23 10:27 PM
DELIVERY NEEDED 03/19/24 2:54 PM
10/02/23 10:24 PM
FUEL QUALITY ALM 10/02/23 10:33 PM
TANK 3 T3-Premium
SETUP DATA WARNING 03/19/24 2:53 PM
HIGH WATER ALARM 10/02/23 10:32 PM
OVERFILL ALARM 10/02/23 10:40 PM
LOW PRODUCT ALARM 03/19/24 2:55 PM
INVALID FUEL LEVEL 03/21/24 7:20 AM
PROBE OUT 03/20/24 3:35 PM
03/20/24 9:27 AM
03/19/24 9:10 PM
HIGH WATER WARNING 03/19/24 2:55 PM
10/02/23 10:32 PM
DELIVERY NEEDED 03/19/24 2:55 PM
10/02/23 10:29 PM
TANK 4 T4-Diesel
SETUP DATA WARNING 03/19/24 2:53 PM
HIGH WATER ALARM 03/19/24 2:56 PM
10/02/23 10:45 PM
OVERFILL ALARM 10/02/23 10:51 PM
LOW PRODUCT ALARM 03/19/24 3:36 PM
10/02/23 10:42 PM
INVALID FUEL LEVEL 03/19/24 3:36 PM
PROBE OUT 03/20/24 3:17 PM
03/20/24 9:34 AM
HIGH WATER WARNING 03/19/24 2:56 PM
10/02/23 10:45 PM
DELIVERY NEEDED 03/19/24 3:36 PM
10/02/23 10:42 PM
+AAMAAQ-
I30100
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 Unld.T1 STP Sump Normal
2 Unld.T2 STP Sump Normal
3 Prem.T3 STP Sump Normal
4 DIE. T4 STP Sump Normal
5 Unld. T1 Int. Space Normal
6 Unld. T2 Int. Space Normal
7 Prem./DIE T3/T4 Int Normal
8 UDC FP 1-2 Normal
9 UDC FP 3-4 Normal
10 UDC FP 5-6 Normal
11 UDC FP 7-8 Normal
12 UDC FP 9-10 Normal
13 UDC FP 11-12 Normal
14 UDC FP 13-14 Normal
15 UDC FP 15-16 Normal
+AAMAAQ-
I30200
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 Unld.T1 STP Sump
03/20/24 3:16 PM SENSOR OUT ALARM
03/20/24 2:59 PM SENSOR OUT ALARM
03/20/24 2:26 PM FUEL ALARM
10/02/23 10:04 PM SENSOR OUT ALARM
10/02/23 8:11 PM FUEL ALARM
09/28/23 2:14 AM FUEL ALARM
2 Unld.T2 STP Sump
03/20/24 3:30 PM SENSOR OUT ALARM
03/20/24 2:27 PM FUEL ALARM
10/02/23 10:04 PM SENSOR OUT ALARM
10/02/23 8:11 PM FUEL ALARM
09/28/23 2:15 AM FUEL ALARM
3 Prem.T3 STP Sump
03/20/24 3:38 PM SENSOR OUT ALARM
03/20/24 2:28 PM FUEL ALARM
10/02/23 8:12 PM FUEL ALARM
09/28/23 2:13 AM FUEL ALARM
4 DIE. T4 STP Sump
03/20/24 2:29 PM FUEL ALARM
10/02/23 8:12 PM FUEL ALARM
09/28/23 2:12 AM FUEL ALARM
5 Unld. T1 Int. Space
03/20/24 2:58 PM SENSOR OUT ALARM
10/02/23 10:13 PM FUEL ALARM
10/02/23 10:08 PM SENSOR OUT ALARM
10/02/23 9:57 PM FUEL ALARM
10/02/23 9:42 PM FUEL ALARM
10/02/23 8:06 PM FUEL ALARM
10/02/23 7:42 PM FUEL ALARM
10/02/23 7:35 PM FUEL ALARM
10/02/23 7:23 PM FUEL ALARM
09/28/23 1:41 AM FUEL ALARM
09/28/23 1:22 AM FUEL ALARM
6 Unld. T2 Int. Space
03/20/24 3:07 PM SENSOR OUT ALARM
10/02/23 10:10 PM SENSOR OUT ALARM
10/02/23 7:22 PM FUEL ALARM
09/28/23 1:39 AM SENSOR OUT ALARM
09/28/23 1:32 AM FUEL ALARM
09/28/23 1:24 AM FUEL ALARM
7 Prem./DIE T3/T4 Int
03/20/24 3:05 PM FUEL ALARM
03/20/24 3:02 PM SENSOR OUT ALARM
10/02/23 7:24 PM FUEL ALARM
09/28/23 2:45 AM FUEL ALARM
09/28/23 1:33 AM FUEL ALARM
09/28/23 1:29 AM FUEL ALARM
8 UDC FP 1-2
10/02/23 8:15 PM FUEL ALARM
09/28/23 1:23 AM FUEL ALARM
9 UDC FP 3-4
10/02/23 8:16 PM FUEL ALARM
09/28/23 1:23 AM FUEL ALARM
10 UDC FP 5-6
10/02/23 8:17 PM FUEL ALARM
09/28/23 1:24 AM FUEL ALARM
09/28/23 1:12 AM SENSOR OUT ALARM
11 UDC FP 7-8
10/02/23 8:17 PM FUEL ALARM
09/28/23 1:24 AM FUEL ALARM
12 UDC FP 9-10
10/02/23 8:23 PM FUEL ALARM
09/28/23 1:30 AM FUEL ALARM
13 UDC FP 11-12
10/02/23 8:23 PM FUEL ALARM
09/28/23 1:32 AM FUEL ALARM
14 UDC FP 13-14
10/02/23 8:24 PM FUEL ALARM
09/28/23 1:40 AM FUEL ALARM
15 UDC FP 15-16
10/02/23 8:24 PM FUEL ALARM
09/28/23 1:29 AM FUEL ALARM
+AAMAAQ-
I38200
10/02/23 11:24 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
PRESSURE LINE LEAK ALARM HISTORY REPORT
Ln 1: T1 Unleaded
SETUP DATA WARNING 03/19/24 3:22 PM
GROSS LINE FAIL 10/02/23 8:50 PM
PLLD SHUTDOWN ALARM 10/02/23 8:50 PM
SETUP DATA WARNING 10/02/23 1:09 AM
SETUP DATA WARNING 10/02/23 12:47 AM
PLLD SHUTDOWN ALARM 10/01/23 11:35 PM
GROSS LINE FAIL 10/01/23 11:35 PM
SETUP DATA WARNING 09/28/23 1:29 AM
PLLD OPEN ALARM 09/28/23 1:16 AM
PLLD OPEN ALARM 09/28/23 1:14 AM
Ln 2: T2 Unleaded
GROSS LINE FAIL 10/02/23 8:54 PM
PLLD SHUTDOWN ALARM 10/02/23 8:54 PM
GROSS LINE FAIL 10/01/23 11:42 PM
PLLD SHUTDOWN ALARM 10/01/23 11:42 PM
SETUP DATA WARNING 09/28/23 1:46 AM
SETUP DATA WARNING 09/28/23 1:29 AM
Ln 3: T3 Premium
Ln 4: T4 Diesel
PLLD OPEN ALARM 03/20/24 3:19 PM
PLLD OPEN ALARM 03/20/24 3:12 PM
+AAMAAQ-
I38200
10/02/23 11:31 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
PRESSURE LINE LEAK ALARM HISTORY REPORT
Ln 1: T1 Unleaded
SETUP DATA WARNING 03/19/24 3:22 PM
GROSS LINE FAIL 10/02/23 8:50 PM
PLLD SHUTDOWN ALARM 10/02/23 8:50 PM
SETUP DATA WARNING 10/02/23 1:09 AM
SETUP DATA WARNING 10/02/23 12:47 AM
PLLD SHUTDOWN ALARM 10/01/23 11:35 PM
GROSS LINE FAIL 10/01/23 11:35 PM
SETUP DATA WARNING 09/28/23 1:29 AM
PLLD OPEN ALARM 09/28/23 1:16 AM
PLLD OPEN ALARM 09/28/23 1:14 AM
Ln 2: T2 Unleaded
GROSS LINE FAIL 10/02/23 8:54 PM
PLLD SHUTDOWN ALARM 10/02/23 8:54 PM
GROSS LINE FAIL 10/01/23 11:42 PM
PLLD SHUTDOWN ALARM 10/01/23 11:42 PM
SETUP DATA WARNING 09/28/23 1:46 AM
SETUP DATA WARNING 09/28/23 1:29 AM
Ln 3: T3 Premium
Ln 4: T4 Diesel
PLLD OPEN ALARM 03/20/24 3:19 PM
PLLD OPEN ALARM 03/20/24 3:12 PM
+AAMAAQ-
I11C00
10/02/23 11:25 PM
FMS, 5167
WMT +ACM- 5167
1052 Turf Farm Rd.
Payson,UT,84651
Selected Range:
Date Range:10/02/23 12:00 AM - 10/02/23 11:25 PM
Alarm History Report - All Alarms
+ACM- Label Alarm Description Active Clear
T 1 T1-Unleaded OVERFILL ALARM 10/02/23 10:53P 10/02/23 10:59P
T 4 T4-Diesel OVERFILL ALARM 10/02/23 10:51P 10/02/23 10:57P
T 1 T1-Unleaded INVALID FUEL LEVEL 10/02/23 10:50P 10/02/23 10:50P
T 1 T1-Unleaded DELIVERY NEEDED 10/02/23 10:50P 10/02/23 10:50P
T 4 T4-Diesel HIGH WATER ALARM 10/02/23 10:45P 10/02/23 10:53P
T 4 T4-Diesel HIGH WATER WARNING 10/02/23 10:45P 10/02/23 10:53P
T 4 T4-Diesel LOW PRODUCT ALARM 10/02/23 10:42P 10/02/23 10:49P
T 4 T4-Diesel DELIVERY NEEDED 10/02/23 10:42P 10/02/23 10:49P
T 3 T3-Premium OVERFILL ALARM 10/02/23 10:40P 10/02/23 10:46P
T 2 T2-Unleaded OVERFILL ALARM 10/02/23 10:36P 10/02/23 10:41P
T 2 T2-Unleaded HIGH WATER ALARM 10/02/23 10:35P 10/02/23 10:38P
T 2 T2-Unleaded HIGH WATER WARNING 10/02/23 10:35P 10/02/23 10:38P
T 2 T2-Unleaded FUEL QUALITY ALM 10/02/23 10:33P 10/02/23 10:34P
T 3 T3-Premium HIGH WATER ALARM 10/02/23 10:32P 10/02/23 10:38P
T 3 T3-Premium HIGH WATER WARNING 10/02/23 10:32P 10/02/23 10:43P
T 3 T3-Premium DELIVERY NEEDED 10/02/23 10:29P 10/02/23 10:36P
T 1 T1-Unleaded HIGH WATER ALARM 10/02/23 10:28P 10/02/23 10:38P
T 1 T1-Unleaded HIGH WATER WARNING 10/02/23 10:28P 10/02/23 10:38P
T 2 T2-Unleaded HIGH WATER ALARM 10/02/23 10:27P 10/02/23 10:34P
T 2 T2-Unleaded HIGH WATER WARNING 10/02/23 10:27P 10/02/23 10:34P
T 1 T1-Unleaded INVALID FUEL LEVEL 10/02/23 10:25P 10/02/23 10:34P
T 1 T1-Unleaded DELIVERY NEEDED 10/02/23 10:25P 10/02/23 10:35P
T 2 T2-Unleaded INVALID FUEL LEVEL 10/02/23 10:24P 10/02/23 10:24P
T 2 T2-Unleaded DELIVERY NEEDED 10/02/23 10:24P 10/02/23 10:34P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 10:13P 10/02/23 10:18P
L 6 Unld. T2 Int. Space SENSOR OUT ALARM 10/02/23 10:10P 10/02/23 10:14P
L 5 Unld. T1 Int. Space SENSOR OUT ALARM 10/02/23 10:08P 10/02/23 10:13P
L 2 Unld.T2 STP Sump SENSOR OUT ALARM 10/02/23 10:04P 10/02/23 10:11P
L 1 Unld.T1 STP Sump SENSOR OUT ALARM 10/02/23 10:04P 10/02/23 10:10P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 9:57P 10/02/23 10:01P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 9:42P 10/02/23 9:57P
Q 2 T2 Unleaded GROSS LINE FAIL 10/02/23 8:54P 10/02/23 8:57P
Q 2 T2 Unleaded PLLD SHUTDOWN ALARM 10/02/23 8:54P 10/02/23 8:57P
Ln 2 T2 Unleaded LINE OUT 10/02/23 8:54P 10/02/23 8:57P
Q 1 T1 Unleaded GROSS LINE FAIL 10/02/23 8:50P 10/02/23 8:55P
Q 1 T1 Unleaded PLLD SHUTDOWN ALARM 10/02/23 8:50P 10/02/23 8:55P
Ln 1 T1 Unleaded LINE OUT 10/02/23 8:50P 10/02/23 8:55P
L 15 UDC FP 15-16 FUEL ALARM 10/02/23 8:24P 10/02/23 8:28P
L 14 UDC FP 13-14 FUEL ALARM 10/02/23 8:24P 10/02/23 8:28P
L 13 UDC FP 11-12 FUEL ALARM 10/02/23 8:23P 10/02/23 8:29P
L 12 UDC FP 9-10 FUEL ALARM 10/02/23 8:23P 10/02/23 8:29P
L 11 UDC FP 7-8 FUEL ALARM 10/02/23 8:17P 10/02/23 8:21P
L 10 UDC FP 5-6 FUEL ALARM 10/02/23 8:17P 10/02/23 8:20P
L 9 UDC FP 3-4 FUEL ALARM 10/02/23 8:16P 10/02/23 8:25P
L 8 UDC FP 1-2 FUEL ALARM 10/02/23 8:15P 10/02/23 8:26P
L 4 DIE. T4 STP Sump FUEL ALARM 10/02/23 8:12P 10/02/23 8:17P
L 3 Prem.T3 STP Sump FUEL ALARM 10/02/23 8:12P 10/02/23 8:17P
L 2 Unld.T2 STP Sump FUEL ALARM 10/02/23 8:11P 10/02/23 8:18P
L 1 Unld.T1 STP Sump FUEL ALARM 10/02/23 8:11P 10/02/23 8:18P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 8:06P 10/02/23 9:41P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 7:42P 10/02/23 8:05P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 7:35P 10/02/23 7:41P
L 7 Prem./DIE T3/T4 Int FUEL ALARM 10/02/23 7:24P 10/02/23 7:30P
L 5 Unld. T1 Int. Space FUEL ALARM 10/02/23 7:23P 10/02/23 7:35P
L 6 Unld. T2 Int. Space FUEL ALARM 10/02/23 7:22P 10/02/23 7:29P
+AAMAAQ-
I6SU00
10/02/23 11:30 PM
--------------------------------------------------------
+ACoAKgAq- SETUP FOR ALL TANKS +ACoAKgAq-
--------------------------------------------------------
ULLAGE DISPLAY MODE: FULL ULLAGE
USER ULLAGE
FULL ULLAGE LABEL: 100+ACU- ULLAGE
USER ULLAGE: 90+ACU-
PRINT TC VOLUMES: DISABLED
TC REFERENCE TEMPERATURE: 60 DEG F
PERIODIC TEST NEEDED
WARNINGS: DISABLED
DAYS BEFORE PERIODIC WARNING: 25
DAYS BEFORE PERIODIC ALARM: 30
ANNUAL TEST NEEDED WARNINGS: DISABLED
DAYS BEFORE ANNUAL WARNING: 355
DAYS BEFORE ANNUAL ALARM: 365
TC DENSITY: DISABLED
STICK HEIGHT: DISABLED
LEAK TEST REPORT FORMAT: STANDARD
LEAK TEST REGION: EPA
--------------------------------------------------------
+ACoAKgAq- TANK SETUP +ACoAKgAq-
--------------------------------------------------------
--- GENERAL SETUP - TANK 1 ---
CONFIGURED: ENABLED
LABEL: T1-Unleaded
PRODUCT CODE: 1
PROBE NUMBER: Pb 1: Unld. Tk +ACM-1 Probe
PROBE OFFSET: 0.00 INCHES
FULL VOLUME: 19782 GALLONS
DIAMETER: 118.4 INCHES
TILT: 0.00 INCHES
THERMAL COEFFICIENT: 0.000700
METER DATA PRESENT: ENABLED
DELIVERY DELAY: 5 MINUTES
GROSS TEST FAIL: ALARMS DISABLED
PERIODIC TEST FAIL: ALARMS DISABLED
ANNUAL TEST FAIL: ALARMS DISABLED
GOST VOLUME CORRECTION: DISABLED
--- LIMITS - TANK 1 ---
MAX VOLUME: 19782 GALLONS
HIGH PRODUCT: 95+ACU-
DELIVERY OVERFILL: 90+ACU-
DELIVERY LIMIT: 15+ACU-
LOW PRODUCT: 536 GALLONS
HIGH WATER WARNING: 1.00 INCHES
HIGH WATER ALARM: 3.00 INCHES
WATER ALARM FILTER LEVEL: LOW
LEAK ALARM LIMIT: 15 GALLONS
SUDDEN LOSS LIMIT: 50 GALLONS
FUEL LOW TEMP LIMIT: -58.000 DEG F
FUEL HIGH TEMP LIMIT: 140.000 DEG F
--- ENVIRONMENTAL TESTS - TANK 1 ---
TANK TEST METHOD: DISABLED
--- PROFILE - TANK 1 ---
TANK PROFILE: FOUR POINT
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 19782 003 59.2 9883
002 88.8 16039 004 29.6 3735
--- TANK 1 - CHART 1 ---
LABEL: +ACoAKgAqACoAKg-
TYPE: FOUR POINT
SOURCE: USER ENTERED
LAST CHANGE: 2024-03-19
STATUS: ACTIVE
VOLUME ENTRY: TOTAL VOLUME
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 19782 003 59.2 9883
002 88.8 16039 004 29.6 3735
--- TANK 1 ---
T1 SIPHON MANIFOLDED TO
TANKS: 2
T1 LINE MANIFOLDED TO TANKS: NONE
--- ACCUCHART - TANK 1 ---
UPDATE SCHEDULE: NEVER
CALIBRATION PERIOD: 60 DAYS
WARNINGS: ENABLED
MIN OPERATING LEVEL: 10+ACU-
MAX OPERATING LEVEL: 80+ACU-
--- HRM - TANK 1 ---
WARNING LIMIT: 1 GALLONS
ALARM LIMIT: 1 GALLONS
MAXIMUM VOLUME LIMIT: 132 GALLONS
--- GENERAL SETUP - TANK 2 ---
CONFIGURED: ENABLED
LABEL: T2-Unleaded
PRODUCT CODE: 2
PROBE NUMBER: Pb 2: Unld. Tk +ACM-2 Probe
PROBE OFFSET: 0.00 INCHES
FULL VOLUME: 19782 GALLONS
DIAMETER: 118.4 INCHES
TILT: 0.00 INCHES
THERMAL COEFFICIENT: 0.000700
METER DATA PRESENT: ENABLED
DELIVERY DELAY: 5 MINUTES
GROSS TEST FAIL: ALARMS DISABLED
PERIODIC TEST FAIL: ALARMS DISABLED
ANNUAL TEST FAIL: ALARMS DISABLED
GOST VOLUME CORRECTION: DISABLED
--- LIMITS - TANK 2 ---
MAX VOLUME: 19782 GALLONS
HIGH PRODUCT: 95+ACU-
DELIVERY OVERFILL: 90+ACU-
DELIVERY LIMIT: 15+ACU-
LOW PRODUCT: 536 GALLONS
HIGH WATER WARNING: 1.00 INCHES
HIGH WATER ALARM: 3.00 INCHES
WATER ALARM FILTER LEVEL: LOW
LEAK ALARM LIMIT: 15 GALLONS
SUDDEN LOSS LIMIT: 50 GALLONS
FUEL LOW TEMP LIMIT: -58.000 DEG F
FUEL HIGH TEMP LIMIT: 140.000 DEG F
--- ENVIRONMENTAL TESTS - TANK 2 ---
TANK TEST METHOD: DISABLED
--- PROFILE - TANK 2 ---
TANK PROFILE: FOUR POINT
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 19782 003 59.2 9883
002 88.8 16039 004 29.6 3735
--- TANK 2 - CHART 1 ---
LABEL: +ACoAKgAqACoAKg-
TYPE: FOUR POINT
SOURCE: USER ENTERED
LAST CHANGE: 2024-03-19
STATUS: ACTIVE
VOLUME ENTRY: TOTAL VOLUME
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 19782 003 59.2 9883
002 88.8 16039 004 29.6 3735
--- TANK 2 ---
T2 SIPHON MANIFOLDED TO
TANKS: 1
T2 LINE MANIFOLDED TO TANKS: NONE
--- ACCUCHART - TANK 2 ---
UPDATE SCHEDULE: NEVER
CALIBRATION PERIOD: 60 DAYS
WARNINGS: ENABLED
MIN OPERATING LEVEL: 10+ACU-
MAX OPERATING LEVEL: 80+ACU-
--- HRM - TANK 2 ---
WARNING LIMIT: 1 GALLONS
ALARM LIMIT: 1 GALLONS
MAXIMUM VOLUME LIMIT: 132 GALLONS
--- GENERAL SETUP - TANK 3 ---
CONFIGURED: ENABLED
LABEL: T3-Premium
PRODUCT CODE: 3
PROBE NUMBER: Pb 3: Prem. Tk +ACM-3 Probe
PROBE OFFSET: 0.00 INCHES
FULL VOLUME: 11904 GALLONS
DIAMETER: 118.4 INCHES
TILT: 0.00 INCHES
THERMAL COEFFICIENT: 0.000700
METER DATA PRESENT: ENABLED
DELIVERY DELAY: 5 MINUTES
GROSS TEST FAIL: ALARMS DISABLED
PERIODIC TEST FAIL: ALARMS DISABLED
ANNUAL TEST FAIL: ALARMS DISABLED
GOST VOLUME CORRECTION: DISABLED
--- LIMITS - TANK 3 ---
MAX VOLUME: 11904 GALLONS
HIGH PRODUCT: 95+ACU-
DELIVERY OVERFILL: 90+ACU-
DELIVERY LIMIT: 15+ACU-
LOW PRODUCT: 536 GALLONS
HIGH WATER WARNING: 1.00 INCHES
HIGH WATER ALARM: 3.00 INCHES
WATER ALARM FILTER LEVEL: LOW
LEAK ALARM LIMIT: 15 GALLONS
SUDDEN LOSS LIMIT: 50 GALLONS
FUEL LOW TEMP LIMIT: -58.000 DEG F
FUEL HIGH TEMP LIMIT: 140.000 DEG F
--- ENVIRONMENTAL TESTS - TANK 3 ---
TANK TEST METHOD: DISABLED
--- PROFILE - TANK 3 ---
TANK PROFILE: FOUR POINT
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 11904 003 59.2 5936
002 88.8 9700 004 29.6 2183
--- TANK 3 - CHART 1 ---
LABEL: +ACoAKgAqACoAKg-
TYPE: FOUR POINT
SOURCE: USER ENTERED
LAST CHANGE: 2024-03-19
STATUS: ACTIVE
VOLUME ENTRY: TOTAL VOLUME
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 11904 003 59.2 5936
002 88.8 9700 004 29.6 2183
--- TANK 3 ---
T3 SIPHON MANIFOLDED TO
TANKS: NONE
T3 LINE MANIFOLDED TO TANKS: NONE
--- ACCUCHART - TANK 3 ---
UPDATE SCHEDULE: NEVER
CALIBRATION PERIOD: 60 DAYS
WARNINGS: ENABLED
MIN OPERATING LEVEL: 10+ACU-
MAX OPERATING LEVEL: 80+ACU-
--- HRM - TANK 3 ---
WARNING LIMIT: 1 GALLONS
ALARM LIMIT: 1 GALLONS
MAXIMUM VOLUME LIMIT: 132 GALLONS
--- GENERAL SETUP - TANK 4 ---
CONFIGURED: ENABLED
LABEL: T4-Diesel
PRODUCT CODE: 4
PROBE NUMBER: Pb 4: Dies. Tk+ACM-4 probe
PROBE OFFSET: 0.00 INCHES
FULL VOLUME: 7901 GALLONS
DIAMETER: 118.4 INCHES
TILT: 0.00 INCHES
THERMAL COEFFICIENT: 0.000450
METER DATA PRESENT: ENABLED
DELIVERY DELAY: 5 MINUTES
GROSS TEST FAIL: ALARMS DISABLED
PERIODIC TEST FAIL: ALARMS DISABLED
ANNUAL TEST FAIL: ALARMS DISABLED
GOST VOLUME CORRECTION: DISABLED
--- LIMITS - TANK 4 ---
MAX VOLUME: 7901 GALLONS
HIGH PRODUCT: 95+ACU-
DELIVERY OVERFILL: 90+ACU-
DELIVERY LIMIT: 15+ACU-
LOW PRODUCT: 536 GALLONS
HIGH WATER WARNING: 1.00 INCHES
HIGH WATER ALARM: 3.00 INCHES
WATER ALARM FILTER LEVEL: LOW
LEAK ALARM LIMIT: 15 GALLONS
SUDDEN LOSS LIMIT: 50 GALLONS
FUEL LOW TEMP LIMIT: -58.000 DEG F
FUEL HIGH TEMP LIMIT: 140.000 DEG F
--- ENVIRONMENTAL TESTS - TANK 4 ---
TANK TEST METHOD: DISABLED
--- PROFILE - TANK 4 ---
TANK PROFILE: FOUR POINT
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 7901 003 59.2 3959
002 88.8 6358 004 29.6 1558
--- TANK 4 - CHART 1 ---
LABEL: +ACoAKgAqACoAKg-
TYPE: FOUR POINT
SOURCE: USER ENTERED
LAST CHANGE: 2024-03-19
STATUS: ACTIVE
VOLUME ENTRY: TOTAL VOLUME
+ACM- HEIGHT VOLUME +ACM- HEIGHT VOLUME
--- ------ ------ --- ------ ------
001 118.4 7901 003 59.2 3959
002 88.8 6358 004 29.6 1558
--- TANK 4 ---
T4 SIPHON MANIFOLDED TO
TANKS: NONE
T4 LINE MANIFOLDED TO TANKS: NONE
--- ACCUCHART - TANK 4 ---
UPDATE SCHEDULE: NEVER
CALIBRATION PERIOD: 60 DAYS
WARNINGS: ENABLED
MIN OPERATING LEVEL: 10+ACU-
MAX OPERATING LEVEL: 80+ACU-
--- HRM - TANK 4 ---
WARNING LIMIT: 1 GALLONS
ALARM LIMIT: 1 GALLONS
MAXIMUM VOLUME LIMIT: 132 GALLONS
+AAMAAQ-
I70300
10/02/23 11:30 PM
LIQUID MODEL
SENSOR LABEL MODEL
1 Unld.T1 STP Sump Tri-State(Single Float)
2 Unld.T2 STP Sump Tri-State(Single Float)
3 Prem.T3 STP Sump Tri-State(Single Float)
4 DIE. T4 STP Sump Tri-State(Single Float)
5 Unld. T1 Int. Space Tri-State(Single Float)
6 Unld. T2 Int. Space Tri-State(Single Float)
7 Prem./DIE T3/T4 Int Tri-State(Single Float)
8 UDC FP 1-2 Tri-State(Single Float)
9 UDC FP 3-4 Tri-State(Single Float)
10 UDC FP 5-6 Tri-State(Single Float)
11 UDC FP 7-8 Tri-State(Single Float)
12 UDC FP 9-10 Tri-State(Single Float)
13 UDC FP 11-12 Tri-State(Single Float)
14 UDC FP 13-14 Tri-State(Single Float)
15 UDC FP 15-16 Tri-State(Single Float)
16 Tri-State(Single Float)
17 Tri-State(Single Float)
18 Tri-State(Single Float)
19 Tri-State(Single Float)
20 Tri-State(Single Float)
21 Tri-State(Single Float)
22 Tri-State(Single Float)
23 Tri-State(Single Float)
24 Tri-State(Single Float)
25 Tri-State(Single Float)
26 Tri-State(Single Float)
27 Tri-State(Single Float)
28 Tri-State(Single Float)
29 Tri-State(Single Float)
30 Tri-State(Single Float)
31 Tri-State(Single Float)
32 Tri-State(Single Float)
33 Tri-State(Single Float)
34 Tri-State(Single Float)
35 Tri-State(Single Float)
36 Tri-State(Single Float)
37 Tri-State(Single Float)
38 Tri-State(Single Float)
39 Tri-State(Single Float)
40 Tri-State(Single Float)
41 Tri-State(Single Float)
42 Tri-State(Single Float)
43 Tri-State(Single Float)
44 Tri-State(Single Float)
45 Tri-State(Single Float)
46 Tri-State(Single Float)
47 Tri-State(Single Float)
48 Tri-State(Single Float)
49 Tri-State(Single Float)
50 Tri-State(Single Float)
51 Tri-State(Single Float)
52 Tri-State(Single Float)
53 Tri-State(Single Float)
54 Tri-State(Single Float)
55 Tri-State(Single Float)
56 Tri-State(Single Float)
57 Tri-State(Single Float)
58 Tri-State(Single Float)
59 Tri-State(Single Float)
60 Tri-State(Single Float)
61 Tri-State(Single Float)
62 Tri-State(Single Float)
63 Tri-State(Single Float)
64 Tri-State(Single Float)
65 Tri-State(Single Float)
66 Tri-State(Single Float)
67 Tri-State(Single Float)
68 Tri-State(Single Float)
69 Tri-State(Single Float)
70 Tri-State(Single Float)
71 Tri-State(Single Float)
72 Tri-State(Single Float)
73 Tri-State(Single Float)
74 Tri-State(Single Float)
75 Tri-State(Single Float)
76 Tri-State(Single Float)
77 Tri-State(Single Float)
78 Tri-State(Single Float)
79 Tri-State(Single Float)
80 Tri-State(Single Float)
81 Tri-State(Single Float)
82 Tri-State(Single Float)
83 Tri-State(Single Float)
84 Tri-State(Single Float)
85 Tri-State(Single Float)
86 Tri-State(Single Float)
87 Tri-State(Single Float)
88 Tri-State(Single Float)
89 Tri-State(Single Float)
90 Tri-State(Single Float)
91 Tri-State(Single Float)
92 Tri-State(Single Float)
93 Tri-State(Single Float)
94 Tri-State(Single Float)
95 Tri-State(Single Float)
96 Tri-State(Single Float)
97 Tri-State(Single Float)
98 Tri-State(Single Float)
99 Tri-State(Single Float)
+AAMAAQ-
I78000
10/02/23 11:30 PM
PRESSURE LINE LEAK SETUP
Q 1: T1 Unleaded
PIPE TYPE: OPW FLEXWORKS 15
LINE LENGTH: 140 FEET
0.2 GAL/HR TEST: REPETITIVE
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: 1 - T1-Unleaded
PRESSURE OFFSET: 0.0 psi
Q 2: T2 Unleaded
PIPE TYPE: OPW FLEXWORKS 15
LINE LENGTH: 140 FEET
0.2 GAL/HR TEST: REPETITIVE
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: 2 - T2-Unleaded
PRESSURE OFFSET: 0.0 psi
Q 3: T3 Premium
PIPE TYPE: OPW FLEXWORKS 15
LINE LENGTH: 140 FEET
0.2 GAL/HR TEST: REPETITIVE
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: 3 - T3-Premium
PRESSURE OFFSET: 0.0 psi
Q 4: T4 Diesel
PIPE TYPE: OPW FLEXWORKS 15
LINE LENGTH: 150 FEET
0.2 GAL/HR TEST: REPETITIVE
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: 4 - T4-Diesel
PRESSURE OFFSET: 0.0 psi
Q 5:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 6:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 7:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 8:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 9:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 10:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 11:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 12:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 13:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 14:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 15:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
Q 16:
PIPE TYPE: Enviroflex PP1503/2503
LINE LENGTH: 0 FEET
0.2 GAL/HR TEST: DISABLED
0.1 GAL/HR TEST: DISABLED
SHUTDOWN RATE: 3.0 GAL/HR
LOW PRESSURE SHUTOFF: OFF
LOW PRESSURE: 0.0 psi
TANK: NONE
PRESSURE OFFSET: 0.0 psi
INVOICE
DATE
4/4/2024
INVOICE #
21785
BILL TO
Tanknology
David Edens
677 East Lockeford
Lodi, CA 95240
LOCATION
Sam's Club #5167
964 Turf Farm Road
Payson, UT
Precision Testing Technologies, Inc.
2026 West Elk Creek Crt.
Bluffdale, UT 84065
801-886-9224
P.O. NUMBER TERMS
Net 30
Date of Service
Please make checks payable to Precision Testing Technologies, Inc.Total
Balance Due
Payments/Credits
QUANTITY DESCRIPTION RATE AMOUNT
4 Precision Tank Tightness Test 475.00 1,900.00
2 Precision Line Tightness Test 115.00 230.00
2 Line Leak Detector Test 35.00 70.00
6.25 Travel Time (5 Trips)96.00 600.00
400 Miles Traveled (5 Trips)0.85 340.00
$3,140.00
$3,140.00
$0.00
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam’s Club, WM5167
964 Turf Farm Rd
Payson, UT
04/01/2024
19782
7260
7260
Regular
1
4
4
Max LaRou UT-412
5-19-24
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam’s Club, WM5167
964 Turf Farm Rd
Payson, UT
04/01/2024
19782
9361
10421
Regular
2
4
4
Max LaRou UT-412
5-19-24
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam’s Club, WM5167
964 Turf Farm Rd
Payson, UT
04/01/2024
11904
8786
10421
Premium
3
4
4
Max LaRou UT-412
5-19-24
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam’s Club, WM5167
964 Turf Farm Rd
Payson, UT
04/01/2024
7901
3544
4357
Diesel
4
4
4
Max LaRou UT-412
5-19-24
EZY CHEK SYSTEMS TEST DATE
PRODUCT LINE TESTER Testing Company Information
DATA SHEET Name
Address
City
Test Location Information
Precision Testing Technologies, Inc.
2026 W. Elk Creek Crt.
Bluffdale, UT
Test Location Information Phone
Name
Address Technican Information
City Name
Phone Cert #
801-886-9224
Contact
Applied Pressure
#1 Product Type:#2 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.00370.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
#3 Product Type:#4 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.00370.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
#5 Product Type:#6 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.000000.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
Facility ID#
:
04/01/2024
Walmart #5167
964 Turf Farm Rd,.
Payson, UT Max LaRou
UT-412
65 P.S.I.
PRM
0 56
15 56 0 0 0
30 56 0 0 0
PASS
DSL
0 32
15 32 0 0 0
30 32 0 0 0
3DVV
04/01/2024
Max LaRou
UT-412
pei.org 49
Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities
APPENDIX C-9
MECHANICAL AND ELECTRONIC LINE LEAK DETECTORS
PERFORMANCE TEST
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7HVWHU·V1DPH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 7HVWHU·V6LJQDWXUHBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 
Precision Testing Technologies Inc.801-886-9224
Walmart #5167
964 Turf Farm Rd.
Payson, UT
04/01/2024
3
PRM
V.R.
PLLD
4
36
2
4
4
4
4
DSL
V.R.
PLLD
4
45
2
4
4
4
Max LaRou UT-412
United States
Environmental Protection Agency
Washington, DC 20460
Approval expires 04/30/24
OMB No.2050-0068
Notification for Underground Storage Tanks
Implementing Agency Name And Address:IMPLEMENTING AGENCY USE ONLY
ID NUMBER:
DATE RECEIVED:
TYPE OF NOTIFICATION DATE ENTERED INTO COMPUTER:
…A. NEW FACILITY
OR ONE-TIME
NOTIFICATION
(previously deferred
system)
…B. AMENDED …C. CLOSURE OR
CHANGE-IN-
SERVICE
DATA ENTRY CLERK INITIALS:
OWNER WAS CONTACTED TO CLARIFY RESPONSES, COMMENTS:
_____ Number of tanks at facility
_____ Number of continuation sheets attached
What USTs Are Included?An UST system is defined as any one or
combination of tanks that is used to contain an accumulation of regulated
substances, and whose volume (including connected underground piping) is 10
percent or more beneath the ground. Regulated USTs store petroleum or
hazardous substances (see What Substances Are Covered below). This
includes UST systems with field-constructed tanks and airport hydrant fuel
distribution systems.
What Tanks Are Excluded From Notification (see § 280.10 and § 280.12)?
x Tanks removed from the ground before May 8, 1986;
x Farm or residential tanks of 1,100 gallons or less capacity storing motor fuel for
noncommercial purposes;
x Tanks storing heating oil for use on the premises where stored;
x Septic tanks;
x Certain pipeline facilities regulated under chapters 601 and 603 of Title 49;
x Surface impoundments, pits, ponds, or lagoons;
x Storm water or wastewater collection systems;
x Flow-through process tanks;
x Liquid traps or associated gathering lines directly related to oil or gas production
and gathering operations;
x Tanks on or above the floor of underground areas, such as basements or tunnels;
x Tanks with a capacity of 110 gallons or less;
x Wastewater treatment tank systems;
x UST systems containing radioactive material that are regulated under the Atomic
Energy Act of 1954;
x UST systems that are part of an emergency generator system at nuclear power
generation facilities regulated by the Nuclear Regulatory Commission under 10
CFR part 50.
What Substances Are Covered?The notification requirements apply to
USTs containing petroleum or certain hazardous substances. Petroleum
includes gasoline, used oil, diesel fuel, crude oil or any fraction thereof which is
liquid at standard conditions of temperature and pressure (60 degrees
Fahrenheit and 14.7 pounds per square inch absolute). Hazardous
substances are those found in Section 101 (14) of the Comprehensive
Environmental Response, Compensation and Liability Act of 1980, with the
exception of those substances regulated as hazardous waste under Subtitle C
of the Resource Conservation and Recovery Act.
When And Who To Notify?Owners who bring USTs into use after May 8,
1986 must submit this notification form to the implementing agency within 30
days of bringing the UST into use. If the implementing agency requires
notification of any amendments to the facility, send information to the
implementing agency immediately.
Penalties:Any owner who knowingly fails to notify or submits false
information shall be subject to a civil penalty not to exceed $16,000 for each
tank for which notification is not given or for which false information is given.
INSTRUCTIONS AND GENERAL INFORMATION
Please type or print in ink. Also, be sure you have signatures in ink
for sections VIII and XI. Complete a notification form for each location
containing underground storage tanks. If more than 5 tanks are
owned at this location, you may photocopy pages 3 through 6 and use
them for additional tanks.
The primary purpose of this notification form is to provide information
about the installation, existence, changes to, and closure of
underground storage tank systems (USTs) that store or have stored
petroleum or hazardous substances. The information you provide will
be based on reasonably available records, or in the absence of such
records, your knowledge or recollection.
Federal law requires UST owners to use this notification form for
all USTs storing regulated substances that are brought into use
after May 8, 1986, or USTs in the ground as of May 8, 1986 that
have stored regulated substances at any time since January 1,
1974. The information requested is required by Section 9002 of
the Solid Waste Disposal Act (SWDA), as amended.
Who Must Notify?40 CFR part 280, as amended, requires owners
of USTs that store regulated substances (unless exempted) to notify
implementing agencies of the existence of their USTs. Owner is
defined as:
x In the case of an UST in use on November 8, 1984, or brought into use
after that date, any person who owns an UST used for storage, use, or
dispensing of regulated substances; or
x In the case of an UST in use before November 8, 1984, but no longer in
use on that date, any person who owned the UST immediately before its
discontinuation.
Also, owners of previously deferred UST systems with field-
constructed tanks and airport hydrant fuel distribution systems in the
ground as of October 13, 2015 must submit a one-time notification of
existence by October 13, 2018. Owners of UST systems with field-
constructed tanks and airport hydrant fuel distribution systems
brought into use after October 13, 2015 are considered new facilities
and must follow the same notification requirements as all other UST
owners.
I. OWNERSHIP OF USTs II. LOCATION OF USTs
Owner Name (Corporation, Individual, Public Agency, Or Other Entity)If required by implementing agency, give the geographic location of USTs either in decimal
degrees, or degrees, minutes, and seconds. Example: Latitude: 36.123480 (or 36q 7'
24.4"), Longitude: -106.549876 (or -106q 32' 59.6")
Latitude ________________ Longitude ________________
Street Address
County
Facility Name Or Company Site Identifier, As Applicable
… If address is the same as in Section I, check the box and proceed to section III.
If address is different, enter address below:
Street Address
County
City State Zip Code
Phone Number (Include Area Code) City State Zip Code
Utah Department of Environmental Quality, Division of Environmental Response
and Remediation
195 North 1950 West,Salt Lake City,Utah 84116
✔
4
Walmart Inc.
40.028900 -111.755105
Walmart Fueling Station #51672101 SE Simple Savings Drive
Benton
Bentonville
479.258.2364 Payson
AR
UT
72716
84651
964 South Turf Farm Road
Utah
EPA Form 7530-1 (Rev. 6-2015)Electronic and paper versions acceptable.Page 2 of 6
Previous editions may be used while supplies last.
United States
Environmental Protection Agency
Washington, DC 20460
Approval expires xx/xx/xx
OMB No.2050-0068
Notification For Underground Storage Tanks
III. TYPE OF OWNER IV. INDIAN COUNTRY
…Federal
Government
…State
Government
…Commercial
…Tribal
Government
…Local
Government
…Private
USTs are located on land within an
Indian reservation or on trust lands
outside reservation boundaries

Federally recognized tribe where USTs are
located:
V. TYPE OF FACILITY
…Auto Dealership …Federal – Military …Residential
…Commercial Airport Or Airline …Gas Station …Trucking Or Transport
…Contractor …Industrial …Utilities
…Farm …Petroleum Distributor …Other (Explain) ____________________
…Federal – Non-military …Railroad
VI. CONTACT PERSON IN CHARGE OF TANKS
Name:Job Title:Address:Phone Number (Include Area Code):
VII. FINANCIAL RESPONSIBILITY
…I have met the financial responsibility requirements (in accordance with 40 CFR part 280 Subpart H) by using the following mechanisms:
(check all that apply)
…Bond Rating Test …Local Government Financial Test …Surety Bond
…Commercial Insurance …Risk Retention Group …Trust Fund
…Guarantee …Self-insurance (Financial Test)…Other Method (describe here)
…Letter Of Credit …State Fund ___________________________
…I do not have to meet financial responsibility requirements because 40 CFR part 280 Subpart H is not applicable to me (e.g., if you are a state or
federal owner).
VIII. CERTIFICATION (Read and sign after completing ALL SECTIONS of this notification form)
I certify under penalty of law that I have personally examined and am familiar with the information submitted in Sections I through XI of this notification
form and all attached documents, and that based on my inquiry of those individuals immediately responsible for obtaining the information, I believe that
the submitted information is true, accurate, and complete.
Name and official title of owner or owner’s
authorized representative (Print)
Signature Date Signed
Paperwork Reduction Act Notice
The public reporting and recordkeeping burden for this collection of information is estimated to average 30 minutes per response. Responses to this collection of information
are mandatory (40 CFR 280.22). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently
valid OMB control number. This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2050-
0068).
Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden,
including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200
Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.
✔
✔
Sara Gallien Fuel Compliance Manager 2101 SE Simple Savings Drive,
Bentonville, Arkansas, 72716
479.258.2364
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✔
EPA Form 7530-1 (Rev. 6-2015)Electronic and paper versions acceptable. Page 3 of 6
Previous editions may be used while supplies last.
United States
Environmental Protection Agency
Washington, DC 20460
Approval expires xx/xx/xx
OMB No.2050-0068
Notification For Underground Storage Tanks
IX. DESCRIPTION OF UNDERGROUND STORAGE TANKS (Complete for all tanks and piping at this location)
Tank Identification Number Tank No.Tank No. Tank No. Tank No. Tank No.
1. Status Of Tank (check only one)
Currently In Use
Temporarily Closed
Permanently Closed

2. Date Of Installation (month/year)
3. Estimated Total Capacity (gallons)
4. Tank Attributes
(check all that apply)
Asphalt Coated Or Bare Steel ……………
Cathodically Protected Steel
(impressed current)……………
Cathodically Protected Steel
(sacrificial anodes)……………
Coated and Cathodically Protected Steel
(impressed current)……………
Coated and Cathodically Protected Steel
(sacrificial anodes)……………
Composite
(steel clad with noncorrodible material)……………
Concrete ……………
Fiberglass Reinforced Plastic ……………
Noncorrodible Tank Jacket ……………
Lined Interior ……………
Excavation Liner ……………
Double Walled ……………
Manifolded ……………
Compartmentalized ……………
Field-constructed ……………
Double Walled ……………
Unknown ……………
Other, Specify Here ___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
Check Box If Tank Has Ever Been
Repaired ……………
5. Overfill Protection Installed
(check all that apply)
Automatic Shutoff ……………
Flow Restrictor ……………
High-level Alarm ……………
Other, Specify Here ___________ ___________ ___________ ___________ ___________
6. Spill Prevention Installed ……………
Double Walled ……………
T1
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12/07/2023 12/07/2023 12/07/2023 12/07/2023
20,000 20,000 8,000 12,000
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Flapper Valve Flapper Valve Flapper Valve Flapper Valve
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EPA Form 7530-1 (Rev. 6-2015)Electronic and paper versions acceptable. Page 4 of 6
Previous editions may be used while supplies last.
United States
Environmental Protection Agency
Washington, DC 20460
Approval expires xx/xx/xx
OMB No.2050-0068
Notification For Underground Storage Tanks
Tank Identification Number Tank No.Tank No. Tank No. Tank No. Tank No.
7. Piping Attributes
(check all that apply)
Bare Steel ……………
Galvanized Steel ……………
Fiberglass Reinforced Plastic ……………
Flexible Plastic ……………
Copper ……………
Cathodically Protected
(impressed current)……………
Cathodically Protected
(sacrificial anodes)……………
Double Walled ……………
Secondary Containment ……………
Airport Hydrant Piping ……………
Unknown ……………
Other, Specify Here
___________
___________
___________
___________
___________
___________
___________
___________
___________
___________
8. Piping Delivery Type
(check all that apply)
Safe Suction (no valve at tank)……………
U.S. Suction (valve at tank)……………
Pressure ……………
Gravity Feed ……………
9. Substance Currently Stored (or last
stored in the case of closed tanks)
(check all that apply)
*DVROLQHFRQWDLQLQJ”HWKDQRO……………
Diesel ……………
Biodiesel ……………
Kerosene ……………
Heating Oil ……………
Used Oil ……………
*DVROLQH&RQWDLQLQJ!(thanol
(specify amount of ethanol)
___________ ___________ ___________ ___________ ___________
'LHVHO&RQWDLQLQJ!%iodiesel
(specify amount of biodiesel)
___________ ___________ ___________ ___________ ___________
Other, specify here ___________ ___________ ___________ ___________ ___________
Hazardous Substance ……………
CERCLA Name Or CAS Number ___________ ___________ ___________ ___________ ___________
Mixture Of Substances ……………
Please Specify Substances Here ___________ ___________ ___________ ___________ ___________
✔✔✔✔
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EPA Form 7530-1 (Rev. 6-2015)Electronic and paper versions acceptable. Page 5 of 6
Previous editions may be used while supplies last.
United States
Environmental Protection Agency
Washington, DC 20460
Approval expires xx/xx/xx
OMB No.2050-0068
Notification For Underground Storage Tanks
Tank Identification Number Tank No.Tank No. Tank No. Tank No. Tank No.
10. Release Detection
(check all that apply) TANK PIPE TANK PIPE TANK PIPE TANK PIPE TANK PIPE
Manual Tank Gauging ……………
Tank Tightness Testing ……………
Inventory Control ……………
Automatic Tank Gauging …………………………
Vapor Monitoring …………………………
Groundwater Monitoring …………………………
Interstitial Monitoring
(required for new or replaced
tanks or piping)

Statistical Inventory Reconciliation …………………………
Automatic Line Leak Detectors ……………
Line Tightness Testing ……………
No Release Detection Required
(such as some types of suction piping)…………………………
Other Method Allowed By Implementing
Agency …………………………
Other, Specify Here ___________ ___________ ___________ ___________ ___________
X. CLOSURE OR CHANGE IN SERVICE
1. Closure Or Change In Service
Estimated Date The UST Was Last Used
For Storing Regulated Substances
(month/day/year)
___________ ___________ ___________ ___________ ___________
Check Box If This Is A Change In
Service
(i.e., Change of storage to a non-
regulated substance)

2. Tank Closure
Estimated Date Tank Closed
(month/day/year)___________ ___________ ___________ ___________ ___________
(check all that apply below)
Tank Removed From Ground ……………
Tank Closed In Ground ……………
Tank Filled With Inert Material ……………
Describe The Inert Fill Material Here ___________ ___________ ___________ ___________ ___________
3. Site Assessment
Check Box If The Site Assessment Was
Completed ……………
Check Box If Evidence Of A Release
Was Detected ……………
Other, Specify Here ___________ ___________ ___________ ___________ ___________
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T1 T2 T3 T4
PARLUST (1/17) Page 1 of 3
FINANCIAL RESPONSIBILITY - CERTIFICATE OF INSURANCE
FEDERAL UNDERGROUND STORAGE TANK (UST)
NAME AND ADDRESS (of each Covered Location):
SEE ATTACHED SPREADSHEET
POLICY NUMBER:PEC004100110
PERIOD OF COVERAGE: 5/01/23 - 5/01/24
NAME AND ADDRESS OF INSURER (herein called the “Insurer”):
Indian Harbor Insurance Company
Seaview House, 70 Seaview Avenue
Stamford, CT 06902-6040
NAME AND ADDRESS OF INSURED (herein called the “Insured”):
WALMART INC.
702 SOUTHWEST 8TH STREET
BENTONVILLE, AR 72716-6299
1. Indian Harbor Insurance Company , the Insurer, as identified above, hereby certifies that it has
issued liability insurance covering the following underground storage tanks(s):
for taking corrective action and/or compensating third parties for bodily injury and property damage
caused by either sudden accidental releases or non sudden accidental releases or accidental
releases; in accordance with and subject to the limits of liability, exclusions, conditions, and other
terms of the policy; arising from operating the underground storage tank(s) identified above.
The limits of liability are $1,000,000 each occurrence and $2,000,000 annual aggregate, exclusive
of legal defense costs, which are subject to a separate limit under the policy. This coverage is
provided under PEC004100110. The effective date of said policy is 5/01/23.
2. The Insurer further certifies the following with respect to the insurance described in Paragraph 1:
a. Bankruptcy or insolvency of the Insured shall not relieve the Insurer of its obligations under
the policy to which this certificate applies.
Number of Tanks Facility Name Facility Location
SEE ATTACHED
SPREADSHEET
PARLUST (1/17) Page 2 of 3
b. The Insurer is liable for the payment of amounts within any deductible applicable to the
policy to the provider of corrective action or a damaged third-party, with a right of
reimbursement by the Insured for any such payment made by the Insurer. This provision
does not apply with respect to that amount of any deductible for which coverage is
demonstrated under another mechanism or combination of mechanisms as specified in 40
CFR 280.95-280.102 and 40 CFR 280.104-280.107.
c. Whenever requested by the Director of an implementing agency, the Insurer agrees to
furnish to the Director a signed duplicate original of the policy and all endorsements.
d. Cancellation or any other termination of the insurance by the Insurer, except for non-
payment of premium or misrepresentation by the Insured, will be effective only upon written
notice and only after the expiration of sixty (60) days after a copy of such written notice is
received by the Insured. Cancellation for non-payment of premium or misrepresentation by
the Insured will be effective only upon written notice and only after the expiration of a
minimum of ten (10) days after a copy of such notice is received by the Insured.
e. The insurance covers claims otherwise covered by the policy that are reported to the
Insurer within six (6) months of the effective date of cancellation or non-renewal of the
policy except where the new or renewed policy has the same retroactive date or a
retroactive date earlier than that of the prior policy, and which arise out of any covered
occurrence that commenced after the policy retroactive date, if applicable, and prior to such
policy renewal or termination date. Claims reported during such extended reporting period
are subject to the terms, conditions, limits, including limits of liability, and exclusions of the
policy.
I hereby certify that the wording of this instrument is identical to the wording in 40 CFR 280.97(b)(2) and
that the Insurer is licensed to transact the business of insurance, or eligible to provide insurance as an
excess or surplus lines insurer, in one or more states.
c/o AXA XL
505 Eagleview Boulevard
Suite 100
Exton, PA 19341-0636
Date: 10/11/23
(Signature of Authorized Representative of Insurer)
Joseph Madigan, Vice President Authorized Representative of: Indian Harbor Insurance Company
PARLUST (1/17) Page 3 of 3
Facility
#State ID Address City State ZIP UST
1440 8000201 1251 North Main St. Tooele UT 84074 2
1572 9000399 1851 W. Highway 40 Vernal UT 84078 2
1573 5000732 245 South Main Street Price UT 84501 2
1699 3000536 735 West Hill Field Road Layton UT 84041 2
1888 100725 1570 N. Main Street North Logan UT 84341 3
2511 TBD 949 West Grassland Dr. American Fork UT 84003 4
2921 1200676 534 N. Harrisville Rd. Harrisville UT 84404 3
3208 1000996 635 South 1950 West Springville UT 84663 3
3454 100721 1120 S. Commerce Way Brigham City UT 84302 4
3568 4002548 3180 S. 5600 W West Valley City UT 84120 2
3620 TBD 3823 W. 13400 S. Riverton UT 84065 3
3988 1000942 898 S 2550 E Spanish Fork UT 84660 3
4272 TBD 1152 South 100 West Logan UT 84321 3
4696 TBD TBD Heber City UT 3
4718 4002407 11278 South Jordan Gtwy South Jordan UT 84095 4
4730 4002298 7607 S. Campus View West Jordan UT 84084 3
4786 0100638 1275 N. Main Logan UT 84321 3
5109 4002330 4570 S. 4000 West West Valley City UT 84120 3
5167 TBD TBD Payson UT 3
5206 1200677 1710 E. Skyline Dr. Ogden UT 84405 3
5233 4002657 5675 W. 6200 S. Kearns UT 84118 3
5235 TBD 9151 S. Quarry Bend Drive Sandy UT 84094 4
5763 4002666 3590 W. South Jordan Pkwy South Jordan UT 84095 3
5270 1000995 585 N. State Street Lindon UT 84042 3
6683 4002352 6525 South State St. Murray UT 84107 3
6684 1200586 4945 South 900 West St. Ogden UT 84405 3
6685 1000810 1313 University Ave. Provo UT 84601 3
6686 4000263 1905 S. 3000 West Salt Lake City UT 84119 3
7026 8000177 965 Highway 138 Grantsville UT 84029 4
7168 4002671 13352 S Fort Herriman Pkwy Herriman UT 84096 3
UTAH DEPARTMENT OF ENVIRONMENTAL QUALITY (FOR STATE USE ONLY)
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION Date Received:
PETROLEUM STORAGE TANK PROGRAM Facility ID:1000997
Pay Online at:Fiscal Year:2024
DERRpay.utah.gov Invoice No:57407
Fee Pmt Amount:$
Invoice Date: 3/21/2024 Fund Pmt Amt:$
Owner Location Other Pmt Amt:$
SARA GALLIEN
WALMART INC.WALMART SUPERCENTER FUELING STATION #5167
2101 SE SIMPLE SAVINGS DR 964 SOUTH TURF FARM ROAD
BENTONVILLE, AR 72716 PAYSON, UT 84651
Type of Assessment Description of Account Activity Numbers of
Tanks
Charges Credits
Current Charges
1 2024 PST fund Fee Assessment 4 $600.00
Sub Total:$600.00
2 2024 UST Reg Fee Assessment 4 $440.00
Sub Total:$440.00
PAYMENT DUE BY 5:00 P.M. ON 04/20/2024 PAYMENT DUE: $1,040.00
PENALTIES & INTEREST WILL BE ASSESSED ON BALANCES PAST DUE ACCORDING TO UTAH CODE ANN. 19-6-401 et seq.
IF FEES ARE NOT PAID, 60 DAYS AFTER DUE DATE, YOUR CERTIFICATE OF COMPLIANCE LAPSES WITHOUT FURTHER NOTICE.
PAYMENTS ARE APPLIED AS FOLLOWS: (1) PAST DUE BALANCES (2) CURRENT BALANCE (3) PROCESS CHARGES, (4) PENALTIES (5) INTEREST
PAYMENT MUST BE RECEIVED BY 5:00 P.M., IN OUR OFFICE, ON THE DUE DATE TO AVOID PENALTIES & INTEREST.
DIRECT QUESTIONS TO: 801-536-4100 - Accounts Receivable
REMIT PAYMENT WITH INVOICE TO:
ENVIRONMENTAL RESPONSE & REMEDIATION
195 NORTH 1950 WEST - 1ST FLOOR
P.O. BOX 144840
SALT LAKE CITY, UT 84114-4840
NOTE: Please write your facility number on your check stub to insure proper posting to your account.
Please enclose invoice with payment and this invoice will be returned to you as your receipt of payment.