DERR-2024-006431

Page 1 of-L Utah Department of Environmental Quality
APST Equi Verification I nspection
9000409
Addilional Comments:
Ownership of Tanks Location of Tanks
STAKER PARSON MATERIALS AND CONSTRUCTION ROOSEVELT FACILIry
89 WEST 13490 SOUTH, SUITE 1OO 1368 S 3000 W
DRAPER UT 84020 ROOSEVELT UT 84066
Contact Name:#/Email:
SPCC Plan?: Yes No Last Fir€ Marshal lnsp ATG lnfo:
Complete for each tank.fl ####
Capacity of tank (gallons):&bL
Orienlalion of tank:q
Bottom of tank in contact with (soil,
gravel, concrete, not louching):C-ottXfrL-
Substance stored:Dre-(cl(Iort V olt
Date lasl used/depth of product:
Type of spill prevention device:
Type of Piping (Pressure or Suction):--+Does pressure piping have LLD:Yes No @ Yes No CI9 Yes No NA Yes No NA Yes No NA Yes No NA
Spill bucket is clean, intact, etc.No No Yes No Yes No Yes No Yes No
Type of overfill Prevention device:Ar,rto{vldhi /*''.'._S
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified:Yes No ({A'
Pipe kans flex protection method
(Sump, CP, lsolated, Booted):Swrnp ->
,tA-Containment sumps dry:Yes No Yes No (NA Yes No NA Yes No NA Yes No NA Yes No NA
Sump comments
Stage 1 VaporRecovery None2pt None2pt 2pt Coax None 2pt Coax None 2pt Coax None 2pt Coax None
Ptessure Vent Valve is on vents:Yes No I N4 No NA Yes No NA Yes No NA Yes No NA Yes No NA
Secondary containment area
comments:
Complete for each dispenser
!{ /lr
\,,\D cFlex protection method (UDC,
Cathodic Protection, lsolated, Booted):
UDC sump dry:No NA No NA fes ) tlo NA No NA No NA Yes No NA
Fire valve anchored, located below
grade, and without ball valve:
No NAe ret No NA @)*o NA (d ruo NA No NA19 Yes No NA
Comments:
Additional dispenser questions fr #E #F #
Flex protection method (UDC,
Cathodic Proteclion, lsolated, Booted):
UDC sump dry:Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Fire valve anchored, located below
grade, and no ball valve
Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA Yes No NA
Comments:
nI
Financial Responsibility (State Use Only)
FR Method:_ lnaefroo OXZI Yes No by:-
Signatures
I lnspected this facility on_.
Signature:TI
O/O Signature
Attach Tank lnfo Sheet to lnspection with any edits.
Nu lM
Pase2 otL
Show locations of all buildings, streets, tanks, piping, and dispenser
manways and identify each: submersible pump (S), tank fill (F), ATG
(specifo).
Comments:
Utah Department of Environmental Quality
APST Facility Site Plat
NORTH
9000409
5V
tV Rgdor
2o V D"i6e'
Pi€Pen Jtt
pie€el
slo,/g€"r I
s\ave &'r 3
islands. lndicate the product in each tank. Show locations tank
probe (A), interstitial probe (l), vapor recovery (V), capped plug (C), other
SV
'Transition