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Home My WebLink AboutDERR-2025-004697 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 801-261-4054 PRODUCT PIPING INTEGRITY TESTING Facility Name: Double D Distribution Owner: Double D Distribution Address: 1550 South Distribution Drive Address: 1550 South Distribution Drive City, State, Zip: Salt Lake City, Utah 84104 City, State, Zip: Salt Lake City, Utah 84104 Facility I.D.#: Phone #: 801-369-4415 Testing Company: Westech Phone #: 801-266-2545 Date: 3/21/25 This procedure is to test the integrity of product piping. Tests were performed with Petro-Tite line tester. Tank Number 1 1 1 Product Stored DSL DSL DSL Piping Run Main Sat. 2 Sat. 3 Piping Type Flex D/W Flex D/W Flex D/W Test Pressure (PSI) 50 50 50 Test Duration (minutes) 30 30 30 Leak Rate (GPH) 0.000 0.000 0.000 Test Results ☒Pass ☐Fail ☒Pass ☐Fail ☒Pass ☐Fail ☐Pass ☐Fail Comments: Tester’s Name Taber DeHart, UT-0394 Tester’s Signature Sat. 3 3 Sat. 2 2 1 20 K DSL AST Spill Bucket AST Annual Visual Inspection Checklist (Revised 05/11/2023) Facility ID#: Facility Name: Inspection Date: Street Address: City: ZIP: # of Tanks Inspected: Tank ID Numbers: Any item marked “No” requires additional information to describe the condition and date the condition is corrected. ITEM STATUS COMMENTS / DATE CORRECTED Containment 1 Is the containment structure in satisfactory condition (diking, impounding, double-wall tank, etc.)? Yes No 2 Are the drainage pipes/valves in good working condition for continued service? Yes No N/A Tank Foundation/Supports 3 Free of tank settlement or foundation washout? Yes No 4 Concrete pad or ring wall free of cracking or spalling? Yes No 5 Tank supports in satisfactory condition? Yes No 6 Is water able to drain away from tank? Yes No 7 Is the grounding strap between the tank and foundation/supports in good condition? Yes No N/A Cathodic Protection 8 Are cathodic protection system in operating condition and functional? Yes No N/A 9 Rectifier reading Volts: ________ Amps: _______ Are these readings within manufacturer specifications? Yes No N/A Tank External Coating 10 Free of visible signs of paint failure? Yes No Tank Shell / Heads 11 Free of noticeable shell/head distortions, buckling, denting, or bulging? Yes No 12 Free of visible signs of shell/head corrosion or cracking? Yes No Tank Manways, Piping, and Equipment 13 Flanged connection bolts tight and fully engaged with no sign of wear or corrosion? Yes No N/A Tank Roof 14 Free of standing water on roof? Yes No 15 Free of visible signs of coating cracking, crazing, peeling, or blistering? Yes No 16 Free of holes? Yes No AST Annual Visual Inspection Form Page 1 of 2 Double D Distribution 3/21/2025 1550 South Distribution Drive SLC, Utah 84104 1 20,000-Gallon DSL AST 4 Double-wall tank 4 4 Tank on Saddles 4 4 4 4 4 4 4 4 4 4 4 4 4 ITEM STATUS COMMENTS/DATE CORRECTED Venting 17 Normal and emergency vents free of obstructions? Yes No 18 Normal vent on tanks storing gasoline equipped with pressure/vacuum vent cap? Yes No N/A 19 Is the emergency vent in good working condition and functional, and tested as required by manufacturer? Yes No Insulated Tanks 20 Free of missing insulation? Yes No N/A 21 Insulation free of noticeable areas of moisture? Yes No N/A 22 Insulation free of mold? Yes No N/A 23 Insulation free of visible signs of damage? Yes No N/A 24 Insulation adequately protected from water intrusion? Yes No N/A Level and Overfill Prevention Equipment 25 Electronic or mechanical liquid level gauge tested for proper operation? Yes No N/A 26 Electronic or mechanical liquid level gauge calibrated during the previous 12 months? Yes No N/A 27 Is overfill prevention equipment in good working condition? Overfill Valve Audible Alarm Both Yes No N/A Verified by: Inspection Date: Operational? Yes No Repair Date: 28 Is tank ullage being determined and documented before filling the tank? Yes No N/A Electrical Equipment 29 Is tank/equipment grounding adequate and in good condition? Yes No 30 Is electrical wiring for control boxes, lights, and other high voltage equipment in good condition? Yes No N/A Additional Comments Inspector Information (Certified Individual or Professional Engineer) Printed Name: Signature: Date: AST Annual Visual Inspection Form Page 2 of 2 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 Taber DeHart 3/21/2025 2025 UST CERTIFICATE OF COMPLIANCE ISSUED TO:LOCATION OF TANKS: SKYLER DROUBAY DOUBLE D DISTRIBUTION DOUBLE D REAL ESTATE 1550 S DISTRIBUTION DRIVE 1550 S DISTRIBUTION DRIVE SALT LAKE CITY UT 84104 SALT LAKE CITY, UT 84104 Facility ID: 4002704 Tank #Capacity Substance Desc Compliance Financial Assurance Mechanism 1 20000 Diesel Yes This certificate will automatically lapse if any of the required fees are not paid. It may also be revoked for failure to comply with state and federal UST regulations. Possession of this certificate does not signify coverage under the Utah PST Fund. Cleanup requirements may be obtained from the Division of Environmental Response and Remediation. UTAH DEPARTMENT OF ENVIRONMENTAL QUALITY Underground Storage Tank Inspection Verification Form Facility ID:4002704 Owner Name:DOUBLE D REAL ESTATE Facility Name:DOUBLE D DISTRIBUTION Owner Address:1550 S DISTRIBUTION DRIVE Street Address:1550 S DISTRIBUTION DRIVE SALT LAKE CITY, UT 84104 SALT LAKE CITY, UT 84104 Operator A:No Data / No Data / Operator B:No Data / No Data / Owner Email:skylerd@doubleddistribution.com UTM Coordinates X/Y:416607 / 4509985 Disp ID/Alt ID Substance UDC Pipe Flex Loc Install Date UDC Install Date Fire Valve Sat Present UDC Test Disp Flex CP Test 1 - 1/2 Diesel Yes Steel Flex in Sump 11/02/2018 11/02/2018 No Yes 2 - 3 Diesel Yes Steel Flex in Sump 11/01/2018 11/01/2018 No Yes Tank ID/Alt ID:1 / 1 EGen/AST/Stat e: No / Yes / Yes Pipe Material-Mod:Flexible Plastic - Double-Walled Siphon/Compart:No / No PVV/StageI:No Pipe Type/STP Cont: / No Tank Status:Currently In Use None STP Flex Connectors:Steel Flex in Sump Installed/Cap/Loc:11/1/2018 / 20000 / LLD Model: Substance Stored:Diesel / Diesel #2 (U.L.S.)Spill/Overfill/Sm deliv:Dry Connect Fitting / Automatic shutoff / No Tank Material-Mod:Asphalt Coated or Bare Steel - Double-Walled PST Fund/Other Type:No / ATG: / Tank/Pipe Rel Det:OTHER / LTT / NONE ATG Specs: / / STP Sump Test:Spill Bk Test: ATG Test:PVV Test:Overfill Test: LTT Test:LLD Test:CP Tank Test:CP Pipe Test: 6/24/2025 Page 1 of 1 Page 1 Version 10.12.2021V1 Utah Notification for Aboveground Petroleum Storage Tanks Division of Environmental Response and Remediation Underground Storage Tank Section P.O. Box 144840 Salt Lake City, Utah 84114-4840 Phone # (801) 536-4100 Fax # (801) 359-8853 Email: TankCompliance@utah.gov Web site: deq.utah.gov STATE USE ONLY Facility ID #: _____________ Date Received: ___________ Data Entry Clerk Initials: ____ This form must be completed for each location containing aboveground petroleum storage tanks (APSTs) that are regulated by the State of Utah. I.Ownership of tank(s)II.Location of tank(s) Owner Name _________________________________________ Mailing Address _______________________________________ City ____________________ State ___________ Zip _________ Contact______________________________________________ Phone # ____________________ Cell # ____________________ E-mail _______________________________________________ Facility ID # (unless new location) ____________________________ Facility Name _________________________________________ Street Address ________________________________________ County ________________City ________________ Zip _______ Facility Phone #______________ Latitude: ________________ Longitude: ________________ III.Type of Notification IV.Other New Notification Amended Notification Located on land within an Indian reservation or on other Indian trust lands. Name of Tribe:_____________________________________ Federally regulated underground storage tanks are at this location. If so, please enter the Facility ID assigned in the space above under Section II. V.Type of Owner VI.Type of Facility VII.Exempt Commercial Private Federal Government State Government Local Government Tribal Government Auto Dealership Contractor Federal – Non-military Federal – Military Gas Station Industrial Railroad Residential Trucking or Transport Utilities Other (explain) _________________________ Commercial Airport(fueling) Farm/Agriculture Petroleum Distributor/Refiner (SIC Code 2911 or 5171) Oil or Gas Production and Gathering Heating Oil used on premises Less than 501 gallons VIII.Contact Person in Charge of Tanks Name: Job Title: E-mail:Address: Phone Number (Include Area Code): IX.Financial Responsibility I plan to meet the financial responsibility requirements by using the following mechanism(s): (check all that apply) Bond Rating Test Commercial Insurance Guarantee Letter of Credit Local Government Financial Test Risk Retention Group Self-insurance (Financial Test) State Fund (Petroleum Storage Tank Fund) Surety Bond Trust Fund Other Method (explain) __________________________________ X.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, believe that the submitted information is true, accurate, and complete. __________________________________________________________________________________________________________ Name and official title of owner or owner’s Signature Date Signed Authorized representative (Print) Page 2 Version 10.12.2021V1 XI.Description of Aboveground Petroleum Storage Tanks (complete for each tank at this location) Tank Identification Number (use additional pages if more than 5 APSTs) Tank # Tank # Tank # Tank # Tank # 1.Tank system description (check all that apply) (if either of these apply, the ApST is regulated) Rests directly on soil (including gravel) Any portion of piping buried or touches soil (including gravel) 2.Status of Tank (check only one) Currently in Use Temporarily Closed 3.Date of Installation 4.Capacity (501 gallons and greater) 5.Tank Attributes (check all that apply) Asphalt Coated or Bare Steel Cathodically Protected Steel (impressed current) Cathodically Protected Steel (sacrificial anodes) Composite (steel clad with non-corrodible material) Concrete Double Walled Manifolded Compartmentalized Field – constructed Steel Secondary Containment Concrete Secondary Containment Earthen Secondary Containment Tank rests on cradles UL Listed APST Connected to an Emergency Generator Other, Specify Here ____________ ___________ ___________ ___________ ___________ 6.Overfill Protection (check all that apply) Automatic Shutoff High-level Alarm 7.Spill Prevention Single Walled Dry Connect Fitting Other, Specify Here ____________ ___________ ___________ ___________ ___________ Page 3 Version 10.12.2021V1 8.Vapor Recovery Attributes (check all that apply) Pressure Vent Valve on Vent Pipe Coaxial Drop Tube at Tank Two Point Vapor Recovery at Tank Emergency Venting 9.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 ____________ ___________ ___________ ___________ ___________ 10.Piping Flexible Connectors (tank end) Containment sump Booted Not in contact with soil Cathodically Protected (impressed current) Cathodically Protected (sacrificial anodes) 11.Piping Flexible Connectors (dispenser end) Containment sump Booted Not in contact with soil Cathodically Protected (impressed current) Cathodically Protected (sacrificial anodes) 12.Piping Delivery Type Safe Suction (no valve at tank) U.S. Suction (valve at tank) Pressure Gravity Feed Page 4 Version 10.12.2021V1 13.Substance Gasoline - Regular (up to 10% ethanol) Gasoline - Midgrade (up to 10% ethanol) Gasoline - Premium (up to 10% ethanol) Gasoline – Ethanol Free Gasoline Containing > 10% ethanol (specify amount of ethanol and grade of product) Diesel Off Road Diesel Biodiesel Diesel Containing > 20% biodiesel (specify amount of biodiesel) Kerosene Avgas Jet Fuel New Oil Used Oil Other, specify here ____________ ____________ ____________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ ___________ 14.Release Detection (check all that apply)Tank Pipe Tank Pipe Tank Pipe Tank Pipe Tank Pipe Tank Tightness Testing Automatic Tank Gauging Interstitial Monitoring Statistical Inventory Reconciliation Automatic Line Leak Detectors Line Tightness Testing Comments 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 Double D Real Estate Double D Distribution 1550 S Distribution Drive 1550 S Distribution Drive Salt Lake City Utah 84104 Salt Lake City 84104 Skyler Droubay 801-364-6565 Skyler Droubay 801-364-6565 1 AST 11-2018 20,000 Diesel 1 Pass Pass zero Insurance 3-21-25 4002704 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 4002704