DERR-2025-004126

Page l of二 Utah Department of Environmental Quality
UST Release Detection lnspection
0100713
Ownership of Tanks Location of Tanks
C/O Barghsussn Consulti.g Engineers, lnc.COSTCO VIHOLESALE#1633
18215 72nd Avenue Soし い 1170N1000 VV
КENT IVVA 198032 LOCAN IUT 184321 _122
oP A rLRt OAVTLS l(,t40) 3966090 OP B韓 轟壽‐‐任Sr.ィ 餞
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3動
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5-
V.rity r..t on t nk d.t: .h€.i
.r. cqlmt and on fl..O No NA S ngい wa“SⅢl buckelsl Yos No atrA)
l@ No NA ovefrl“vi∞‐(rdi No NA
Ln・ tohlness(suctOn 3yr)Yes Noが ら /;!\ No NA
Qe-s) ro u
Yes No ( i)
Complet tor.lch tank.#ヽ ■3"
‐r″#Capa.ity of lank {oallons}l ヽ●●●0ヽ―●|‐
ヽc、い″鮭 ●´,"_1..“A)).[: te
Oate●sl oま ″depth of prOducll
Typo ol spill p.evenl,on devr ムLェ ●滅
“
議 ―↓→→
Doublo VValbd spil budtet gauge is
checked monthly and vBIdl Ves No NA Yes No NA Yes No NA Ves No NA Yes No NA
Spillbuckel is clean, intact, et..O No "`=｀ No く
“
置) No
^ No
Type of overlill Prevention devico A"A S0
^‐
A S0
overrl a an (aud b e or vist01e)'S propoly 10caled so delivery drive. can hear or see it, and is cloaiy idenlilied Yes No G,
STP F ex proteclbn methed(Sump
Cathodic Pioleclon lsolated Booled)S_P S**t S**p S*-+
Conlainrent suhps dry qJ, No NA O No NA @ ro ttr @No NA Yes No NA Ves No NA
Stag€ 1 Vapor Recovery €Eoax None @coax None (@coax None @coar None
PBsur€ Vent Valve is on venlsl C No NA t@ No NA @rou @No NA Yes No NA Yes No NA
Compl.t. tor sach dlsp.ns.r ″ ヽ/ヶ 3/4 " γl ″7/g
'■4。″l1/t2
F ox proleclon method(UDC
Cathodic Prolect on so ated Booled)嗅ゆ`tt Oこ
“
bι tt Oこ 颯 0こ ヽ0こ
@No re c自 当ノ No NA
…
No NA ― No NA (@ tlo ra ゅ No NA
OW piping havejumpe.s in pla@l Yos No い Yes No NA Yes No NA Yes No !A Ves No NA Yes No い
Fne v6lve anchoEd, lo@ted below
grad6, and withort ball v.lve
ひ No NA &NoNA ゛ No NA (@ No NA
“' No NA @No Ne
Addltlonal dlspcnser queBtion3 #1,各 ′=/′●′%′″11/3.″`う 4ν
F ex proleclon method(UDC
Cathodic P,otecllon lsolated Bootet〉
“
oι
“
OC
“
oc
“
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OC
“
0こ
と,' No NA a撃 ´) No NA .‐ヽ No NA め No NA の No NA o No NA
OW piping havejumpeB in pla@:Yes No NA Yes No NA Yes No NA Yes No しヽ Yes No M Yes ■~Fire valv6 anchoEd, l@ted bdd
gEde. and no ball valve:
@NoNA ´ No NA <trD No NA {@ No NA <!E) No NA `″
素｀ No NA
lhpr....d Cur.hl Cathodlc Prol..tlon lasl thre dales rocdtier .h*ked:
Flnancial R6ponsibility {sraro U& Only)
`豪
務′ No FR Method l Method OК ,I Yes No by:
"ジ
N。
'C'Operato6 tainod or unmanned sile srgn s visible?@ tto re l Maよ マ″メ rnsp€cl€d uris racihty on ,. rt-Z t .lllhe slte is unmanned and disoensestuel. d@s rl have
@ No NAan emeqency shutoff devicez S"圏
ェ ι
TI
′′73Monthly chechist aval●Ob and comp ele?O N。
‐7盗
Page 2 of=Z_
D{ oothly monitonns
Tank and
Automatic Tank
Piping Release Detection
Gauging/lnterstitial Monitoring
0100713
Tank! inslallod aft r Octob.r 1 , 2008 mult do l.tor6tiiial iioniloring.
〕2 9ph mOnthly test
l SIR
li hterstial monilo.ing Type of[M?く
=9∝
Manu“
:〕VapOr mOn lolng
【 】ATC Coounoous test1 l ATC Shutdowntest
74S タManufactur€r and t odolof sysrom:
Yes or No for 6ach question, tn th€ last@lumn, expLan and id€nti, by tankany olcoptionslo th6 answe6 giv6n in lhelirstolumn
Type ol lM docum6nlalion u*d:Typ€ of secondary conlaanm6nt us6d:
Sy6lom i6 capable of deleclinq a rc166s6 ol rcgulaled subslanc.s lrom 6ny
ponion of rE piimrry ttnk/plplng within om monlh ol rcloas€:
ATG @n$b or orh6r 6quipm6nl us€d to iake rsading6 and p6dorm l6sts is
ad€qoat6, ac@3sabl6, and oporational:ATG IM
I■●%"Mht。‐i●●
“
●k“
鮨,卜 oま し AIG Shadom,。ま:The tank was nlbd to at leasl tho minimum l6v6lr€qui.ed loensu6 a valid l6ak
l€sl. and lhe tank size iswilhin lh€ allow€d upporand l 6r siz6limils
how rcsulk ofmonitoring for!.ch iantforth. lacr l2 month3. lndicat! Pass, Fall,Inv.lid, orNo R6sulG lor.ach month, FoTATG Shutdown Gsts,
the highest p.oduct revelrested ror each month.
Prsssu.izod piping must h6ve an Automalrc Lim L6ak Doioclor and ons oth6. lom of l€ak dal€c1io..Plphg L..t O.i.ctlon
ll|dlcrtc Ol€ m€ttod u.€rl:
Suclion piping musl b€ l6sled ev6ry 3 years or havs monthly monnoring. f saf€ suclim. l6ak doloclion is dolercd
Plping in3talに d alto7 0CtObo,1,2003 must do!nterstitial Mon toring〔 ]Line teak Detector rest n9
〔 ]Line TIghtness Testing
C_は _ctt C・r strU b.J-t rzpL-*.*\r
Ver i075 2018