DERR-2024-006069

Utah DEQ Underground Storage Tank
Installation Notification Form
www.undergroundtanks .utah .gov
Facility ID 4002689 I New UST Install ~ I Upgrade/Repair D
Installation Company: Csesco, Inc.
Contact Name: Tracy Boswell I Phone: [phone]
Address: 830 West Northpointe Circle, North Salt Lake, Utah 84054
Certified Installers/Technicians on project
Name Luke A. Kelso Cert. # TL 0416
Name Conner Christensen Cert. # TL0457
Name Zane Christensen Cert. # TL0456
Tank Owner: Maverik, Inc.
Address: 185 South State Street, # 800 -Salt Lake City, Utah 84111
State Use Onlv
Permit Required? ~
Permit# 1697-2024-8
Base Fee $ 500
Inspection Fee* $200 x ~ $ 1000.00
PST Install Fee $200 x 2.._ $ 1ooo.oo
Total s2soo .oo
Date Approved & Paid 3·/8-21>2'-/:
*Appl ies in non-LHD contract areas
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Exp . Date eoruary 1, 2026
Exp. Date February 1, 2026
Exp . Date February 1, 2026
Contact Name: Mamun Rashid I Phone# [phone]
Facility Name: Maverik# 747 -Salt Lake City
Facility Address: 2359 California Avenue -Salt Lake City, UT 84104
Installation / Upgrade /Repair Information I Est. Date work will commence: 3/26/2024
Tank# lA 1B 2 3A 3B
Capacity 15,000 10,000 40,000 8,000 9,000
Tank Material FRP DW FRP DW FRP DW FRP DW FRP DW
Piping Material Flexible DW Flexible DW Flexible DW Flexible DW Flexible DW
Substance stored Unleaded Unleaded Diesel Ethanol Free Premium
Check if upgrade or repair only. D (Describe details below)
Describe Details of Install/Upgrade/Repair in the box below (Submit a drawing/site map of work to be done)
Install (3) new Xerxes double wall fiberglass UST's (TWO-Multi-Compartment) for a total (5) new regulated tanks/
compartments. Install (6) new polyethylene dispenser sumps. Install new 11/2", 2", and 3" OPW Flexworks
double wall flexible product piping inside 4" and 6" access pipe to the (14) new dispenser sumps. Install new
Veeder Root TLS-450 Plus ATG with (6) In-Tank Probes, (3) interstital tank sensors, (20) sumps sensors, and a
remote overfill alarm for overfill prevention. Install (7) 2 HP Red Jacket Submersible Pumps with DPLLD's. Install
Single Wall Fiberglass vent lines underground to the vent risers at the new canopy columns. Install (8) new
Gilbarco Blender Dispensers and (6) High Flow Diesel Dispensers with DEF. RECEIVED
f' AR 1 202
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Mail completed form to: 195 N. 1950 W. ist Floor Q '1 r:(J Jt I
UiAH Of.PARTMENT of
DEQ/DERR Salt Lake City, Utah ENV IRONMl;rJTAL QUALITY
Box 144840 Phone[phone] ENVIRONMENTAL RESPONSE
Salt Lake City, Utah 84114-4840 Fax[phone] & REME D IATfON
Ver . 8/1/2016