DERR-2025-005355

Report Submitted by:
Date Received:
3/4/2025
Chelsea A Qualls
Date Assigned:
Date Confirmed:
3/3/20254002610
Mark Crim
Facility ID No:
Project Manager:
No
OMV
(for DERR use only)
Release ID:
Potential PST Funded Site?:
Russell Hicks
Maverik
RASHID MAMUN
MAVERIK #669
279 S. 5600 W.
Name of Reporting Party:
Rptng Party Company Name:
Company Contact:
Name of Release Location:
[phone]
[phone]
[phone]
SALT LAKE CITY
Reporting Party Phone:
Company Contact Phone:
Release Location Phone:
Release Site City:
RELEASE INFORMATION
Release Date:
Product Released:
Cause of Release:
Source of Release:
Method of Determination:
Diesel
Overfill
Visual Evidence
Dispenser
Federally Regulated LUST Site?
AST?
Yes
No
Release Site Street Address:
INITIAL ABATEMENT / CORRECTIVE ACTION
No
AGENCIES NOTIFIED
LHD:DEQ/DERR:FIRE:
EPA:OTHER:
Yes Yes No
No
Store personnel used absorbent and contacted Environmental Restoration for cleanup, which is
in progress.
Multiple releases occurred in short period of time. One was 25 gallons, other was 15. See reports
and emails for more details.
Comments:
Yes Action Performed?
If Yes Explain:
UTAH DERR/LUST RELEASE REPORT