DERR-2024-006248

Page I ofI Utah Department of Environmental Quality
APST Equipment Verification lnspection
9000221
Ownership of Tanks Location of Tanks
WIND RIVER PETROLEUM TOP STOP C-40
5097 S 900 E, SUTTE 200 1355 E HWY 40
SALT LAKE CITY UT 84117 VERNAL UT
Contact Name #/Email
SPCC Plan?: Yes No Last Fire Marshal lnsp:ATG lnfo:
Complete for each tank.# i tL\V:. )-# Lfi.tv"i # \ tily.'-L|# tt Au..'.3 #<hv'"s #
Capacity of tank (gallons)11 v ())L 4iA\ ov lDk.
Orientation of tank:
J-1r lz.
N nYl4n Covrter
-.t
N
rtia
o{-'Yh tnu,.-*t r €r^,"1^ f pv*tK 9n<P
Bottom of tank in contact with (soil,
gravel, concrete, not touching)Ortrvq.\--+
Substance stored {?ealrlnV r'\rrtvdtx,l '?vrr\nnir rVn tjpar Tjpcrl Q.t A f\ n, lte
Date last used/depth of product:L 24---,-+'Type of spill prevention device:36 3B Utanr{nlrl GB
Type of Piping (Pressure or Suction):
Does pressure piping have LLD Yes No (9 Yes No qD No@Yes No CIEYes (I9Yes No Yes No NA
Spill bucket is clean, intact, etc.No (\c9 No Ye) No No No Yes No
Type of overfill Prevention device
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified:Yes No €4-
Pipe trans flex protection method
(Sump, CP, lsolated, Booted)St^*e __-+
Containment sumps dry Yes No N4 Yes No (.l{)Yes No Yes No Yes No Yes No NA
Sump comments:
Stage 1 Vapor Recovery:None2pr None2pt None2pt 2pt ) None 2pt 2pt Coax None
Pressure Vent Valve is on vents:No NA Yes No (NA)DNo NA Yes No Yes No Yes No NA
Secondary containment area
comments:
Complete for each dispenser #7,E 7IL1 frC Ito E trltZ
Flex protection method (UDC,
Cathodic Protection, lsolated, Booted):$ooleA --*)Suvrg -)
UDC sump dry:iruoNA (Y"J No NA Vid No NA No NA No NA dBg No NA
Fire valve anchored, located below
grade, and without ball valve:@t No NA tF No NA '\bi No NA (9 No NA @ No NA @ No NA
Comments:
Additional dispenser questions #li tLl # lbll{o tr #E
Flex protection method (UDC,
Cathodic Protection, lsolated, Booted):Sr.-vnP --
-)UDC sump dry:No NA @)NoNA (d No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored, located below
grade, and no ball valve:
No NA(9 V9} No NA No NA(9 Yes No NA Yes No NA Yes No NA
Comments:
I'fV-i'Eil,
Additional Comments:Financial Responsibility (State Use Only)
FR Method:_Method OK?Yes No
Signatures
lnspected this facility on_
Signature:TI
O/O Signature
Attach Tank lnfo Sheet to lnspection with any edits.
Page 2 of L Utah Department of Environmental Quality 9000221
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islands. lndicate the product in each tank. Show locations of tank
nk fill (F), ATG probe (A), interstitial probe (t), vapor recovery (V), capped ptug (C), other
Show locations of all buildings, streets,
manways and identify each: submersible
(specifu).
Comments C,?0111 6r egi\\ Vu&zY
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