DERR-2024-005782

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: Mountain States Moving Owner: Mountain States Moving and Storage
Address: 2670 South 3270 West Address: 2670 South 3270 West
City, State, Zip: West Valley City, Utah 84119 City, State, Zip: West Valley City, Utah 84119
Facility I.D.#: 4000628 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 3/15/24
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
Product Stored RUL DSL
ATG Brand and Model TLS 350 TLS 350
1. Tank Volume, gallons 2,000 4,000
2. Tank Diameter, inches 72 72
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? 60 3/8 60 3/4
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: Battery OK
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: Mountain States Moving and Storage Owner: Mountain States Moving and Storage
Address: 2670 South 3270 West Address: 2670 South 3270 West
City, State, Zip: West Valley City, Utah 84119 City, State, Zip: West Valley City, Utah 84119
Facility I.D.#: 4000628 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 3/15/24
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
Product Stored RUL DSL
Spill Bucket
Capacity 5-Gallon 5-Gallon
Manufacturer OPW EBW
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 8” 9 1/16”
Test Start Time 11:27 11:27
Ending Level 8” 9 1/16”
Test End Time 12:27 12:27
Test Period 1 Hour 1 Hour
Level Change 0” 0”
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: Mountain States Moving and Storage Owner: Mountain States Moving and Storage
Address: 2670 South 3270 West Address: 2670 South 3270 West
City, State, Zip: West Valley City, Utah 84119 City, State, Zip: West Valley City, Utah 84119
Facility I.D.#: 4000628 Phone #: [phone]
Testing Company: Westech Phone #: [phone] Date: 3/15/24
This data sheet is for inspecting automatic shutoff devices and ball float valve. See PEI/RP1200 Section 7 for inspection procedures.
Product Grade RUL DSL
Tank Number 1 2
Tank Volume, gallons 2,000 4,000
Tank Diameter, inches 72 72
Overfill Prevention Device Brand OPW OPW
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