DERR-2024-006193

Page 1 of__±:_ Utah D!partment of Environmental Quality
UST Release Detection Inspection
Ownership of Tanks Location of Tanks
BELL BROTHERS OIL COMPANY BELL'S BRIGHAM CITY
PO BOX 238 1096 S 500 W (MEDICAL DR)
0100327
COALVILLE IUT 84017 BRIGHAM CITY luT 84302
OP A: ALLAN BELL [phone] OP B: ALLAN BELL [phone]
Verify tests on tank data sheet Annual Tests 3 Year Tests -
are current and on file. ATG system: h'es) No NA Single walled Spill buckets: ftes) No NA , ....
No NA Line leak detector: No NA Overfill device: 1~)
Line tightness(suction 3yr): (es) No NA Containment sump: No NA
Comments: \Jt){_ SvN -\-u t-S'hovJS o.u<-(}I'\.. ~t /rlf,rllutt "-UDC sump: Yes ~o) NA
<;'h_t..L~ Cathodic Protection: Yes No fiA)
Complete for each tank. '"""-I # 2. #J # i #" ti<,
Capacity of tank (gallons): lo.too \O COO 101 NO n. .l'Xb '-ic()I) \,oeti
Substance stored: PrtMh.iM llui vlov '2.uv~ [)j(\C. \ F-~oi-f.-"4'{ fl< C, vi'-lr
Date last used/depth of product . -------
Type of spill prevention device: o 11-1 s« t)\J S6 O\.J SD s-a S 13 s·.i'
Double Walled spill bucket gauge is 0 _No NA ~No NA ¤) No NA Yes No ¤ 1 Yes No £ > Yes No ¤ checked monthly and valid:
Spill bucket is dean, intact, etc.: \I rey No f~Ye~ No fes) No {!es) No 6-es) No tes) No
Type of overfill Prevention device: ft ri.,-V"\ JtlAr"W\ A~""" A~..,., Al;r~ ll.1-r,,v1.
Overfill alarm (audible or visible) is property located so delivery driver can hear or see it, and is clearty identified: No NA
STP Flex protection method (Sump, B_a_oµ Boe>+~ 8oo«J ~v..,_,, s"'~ ~"" ""'P Cathodic Protection, Isolated, Booted):
Containment sumps dry: (!es_J No NA J'e9 No NA @No NA No NA ~ey No NA (~ No NA --
Sump comments: ----Stage 1 Vapor Recovery: (_2pt_ Coax None 1~t_F<>ax None (£Pj)Coax None 2pt Coax ~my '2p~ Coax None 2pt <{otiy None
Pressure Vent Valve is on vents: (!~ No NA (~ No NA fe_j No NA ~ey No NA No NA ~es_) No NA
Complete for each dispenHr # \ , ~· I] # "i #~ # (J
Flex protection method (UDC, UDt U{)(_ Ut>t Cathodic Protection, Isolated, Booted): U~t U DC. Ub(.
UDC sump dry: ff~ No NA CeJJ No NA No NA No NA t9' No NA ~No NA
OW piping have jumpers in place: No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored, located befow No NA No NA No NA ~No NA No NA No
grade, and without ball valve: --
.--:_:;
Comments:
Additional dispenser questions 11 , " • " • 10 • I\ #
Flex protection method (UOC, VI>t Ut)L vDC Ut) (. Cathodic Protection, Isolated, Booted): U)) C.. ..........
UDC sump dry: ~No NA (e~ No NA ~No NA No NA ~No -NA Yes No NA
OW piping have jumpers in place: Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored, located below No NA 'fas..) No NA No NA ~No NA No NA Yes No NA
grade, and no ball valve:
lmpreaaed Current C.thodic Protection Last three dates rectifier checked:
Operator Training ........... Flnanclal Reaponalblllty (State Uae Only)
•A• Operator current? J.ey No FR Method: I Method OK? I Yes No by:
r ·e• Operator current? ~ey No Signatures
•c• Operators trained or unmanned site sign is visible? M No NA Mo.LL <:+otu If the site Is unmanned and dispenses fuel, does it have No NA
. I Inspected this facility on lo I ti.I l3
an emergency shutoff devtce? Signature:
Tlori l~ -~
Monthly checklist available and complete? r/Y/,tuJ y• . .
comments: / Vl,ct1 ~!..C..J, \IS t-i's lu,ffl) 1£.,..f F °'--C .Q.!_O~~: . ,· --.,. .
r,. l (" 'VI A--A C A :\.1 ,, "'-,.
r ,
Page 2 of 1-Tank and Piping Release Detection
Automatic Tank Gauging/19-terstitial Monitoring
0100327
Tank method used: [ ] A TG Shutdown test l[v(ATG Continuous test [ ] Interstitial Monitoring
Tanks installed after October 1, 2008 must do Interstitial Monitoring.
Manufacturer and Model of system: I
Circle Yes or No for each question. In the last column, explain and identify by tank any exceptions to the answers given in the first column. _,.----.....
IM Type of secondary containment used: Type of IM documentation used{ ,A TG_)Manual
System is capable of detecting a release of regulated substances from any 6:) No
-
IM portion of the primary tank/piping within one month of release:
ATG IM ATG console or other equipment used to take readings and perform tests is G>o adequate, accessible, and operational:
The tank was filled to at least the minimum level required to ensure a valid leak §; No
Third Party Min Level from tank
ATG test, and the tank size is within the allowed upper and lower size limits: NA data sheet for ATG Shutdown test:
Show results of monitoring for each tank for the last 12 months. Indicate Pass, Fall, Invalid, or No Results for each month. For ATG Shutdown tests,
show the highest product level tested for each month.
Mo/Yr 1l'L3 2/2,3 31 23 41 23 5123 6lz3 112.g 8IZ3 9123 10/u. 11/22 12122.
# \ /JA.f~ ,. No t~is
..,,,.,
# 1, flJ.-5) . {o ~tJI~ !ii' /
# g ,~f( ·-.. o L.iuHJ -, ,,.
# 4 '"J(
.. -,
#5 f"-.S5 ....
/041~ , .,.
# (o f'tuS ' Afo t.~11:f -.
Piping Leak Detection Pressurized piping must have an Automatic Line Leak Detector and one other form of leak detection.
Suction piping must be tested every 3 years or have monthly monitoring. If safe suction, leak detection is deferred.
Indicate the method used:
[ ] Line Leak Detector Testing Piping installed after October 1, 2008 must do Interstitial Monitoring.
[ ] Line Tightness Testing [ ] .2 gph monthly test [ ] lnterstial monitoring Type of IM? ATG or Manual
[ ] Monthly monitoring [ ] SIR [ ] GW monitoring [ ] Vapor monitoring
Mo/Yr 1/ 2/ 3/ 4/ 5/ 6/ 7/ 8/ 9/ 10/ 11/ 12/
#
#
#
#
#
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Comments
Ver. 10/5/2018