HomeMy WebLinkAboutDERR-2024-006583Page 1 of oL./Utah Department of Environmental Quality
APST Equipment Verification lnspection
6001 029
Ownership of Tanks Location of Tanks
The Border Store THE BORDER STORE, LLC
PO Box 2763 625 N. STATE STREET
HILDALE IUT 18478/.HTLDALE lur laqu
Contact Name:#/Email
SPCC Plan?: Yes No lLast Fire Marshal lnsp:ATG lnfo:
Complete for each tank.t (aoZZ)2 (76!j(3(7t s5 )#
Capacity of tank (gallons):?;72)2o ZoO Ls 7Z"t
Orientation of tank:t/. *;'-_>
Bottom of tank in contact with (soil,Crf r.rL 2gravel, concrete, not touching):
Substance stored:/ro*r 4'l u^4
Date last used/depth of product:
Type of spill prevention device:ca.t/an ai/L
Type of Piping (Pressure or Suction):€
Does pressure piping have LLD:Yes C/ NA Yes Ng/NA Yes Qo/ run Yes No NA Yes No NA Yes No NA
Spill bucket is clean, intact, etc.:Yes (i,Yes (rrlo/Yes $ld Yes No I Yes No Yes No
Type of overfill Prevention device:/1241 flr.Z--a7raL
Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified:Yes No (N9
Pipe trans flex protection method
(Sump, CP, lsolated, Booted):<-24.,91<- 1
<a 4/.<-a*r.i
Containment sumps dry.ves (ry0l NR Yes 66-l NA Yes Ng/ Na Yes No NA i Yes No NA Yes No NA
Sump comments:
Stage 1 Vapor Recovery:2pt Coax 66ne)2pt Coax (I 2pt Coax Non"/2pt Coax None 2pt Coax None i 2pt Coax None
Pressure Vent Valve is on vents ves ($f run ves @Q NA ves @ NA Yes No NA I Yes No NA I Yes No NA
Secondary containment area
comments:
Complete for each dispenser t/L 3/f # r,//# 7/V #
Flex protection method (UDC,
Cathodic Protection, lsolated, Booted):d0a 40L ut o<_v@a
UDC sump dry:CGy' r'lo NA Yey' ruo NA @NoNA 6d i.ro NA I Yes No NA ' Yes No NA
Fire valve anchored, located below
grade, and without ball valve:
(b/ No NA (9 No NA @ No NA No NA i Yes No NA ! Yes No NA
I
Comments
Additional dispenser questions ##
Flex protection method (UDC,
Cathodic Protection, 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 l'jo NA Yes No NA Yes No NA
Comments:
Additional Comments: I
l*-( fa7s,,k- /.4/-u-b4 * 2Va,'/lT
Financial Responsibility (State Use Only)
Sheet to lnspection wit r any edits
V*/a, re covf
Page 2 of -L
(specify).
Comments:
-1+14
Utah Department of Environmental Quality
APST Facility Site Plat
5/t
/7,a//),14/qo<
6001 029
Showlocationsofall buildings,streets,tanks,piping,anddispenserislands. lndicatetheproductineachtank. Showlocationsoftank
manways and identify each: submersible pump (S), tank fill (F), ATG probe (A), interstitial probe (l), vapor recovery (V), capped plug (C), other
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5o)/. t/t laL ),l",bt- ot piil,? ,
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Underground Storage Tank lnspection Verification Form
Owner lrlame: Tho Bordor Stor6
Owner Addrere: PO Box 278{l
HILDALE, W 84784
Operator A: No Data / No Data /
_ _ _9:"9 EIr3!l: borderstore2@stSifo,
Dlrp lD/Alt Substance UIrc
ID
Plpe Flex
GadDiesel *A f
GaJDiesel j6/y?,
GaJDiesel *y"l
.tsg":"L 5/2-
Facility lD: 6001029
Faclllty Name: THE BORDER STORE, LLC
Street Address; 625 N. STATE STREET
HILDALE, UT U7U
No Data / No Data /
322026 140968r'.7
Operator B:
UTM Coordlnatee Xff:
Loc lnstall Date UDC lnstall Date Fire SatValve Present
Yes No
Yes No
Yes No
Yes No
UDC Teet Dlsp Flex CP
Tert
1-18
2-3/4
3-5/6
4-78
,rr,
Tank lIVAlt lD: 1 l1 (6077)
Slphon/Compart: No / No
Tank Status: Currently ln Us€
lnttalled/Cay'L*: 11111987 I 20720 / South
Substance Slored: Gasoline / Premium
Tank Uaterlal-Mod: Asphalt Coated or Bare Steel - None
ATG: /
ATG Specr: / /
ATG T*t:
LTTTest:LLD Test:
fr 't rildii ro-. 7 E rzosTl - *-Le-"Jrsraut ily*7
Plpe llaterlal-Mod: Galvanized Steel - Secondary Conlainmenl
Plpe TypeETP Cont: P.essurized / No
STP Flex Connectora: St6el Flex in Sump
LLD llodel:
Splll/OverlllllSm dellv: 5 gal. Per Prod. APST Cont. Sump / none / No
PIST Fund/lother Type: Yes /
Tanlt/Flpe Rel [let: T-fT/lC i LTT i NONE
EGen/ASTAttat
PWStagel:
No /Yes /
No
None
STP Sump Test:
CP Tank Test:
Splll Bk Test:
Overlill Teet:
CP Plpe Test:
lnetalledCafl-oci 1n11987 120720 I Cenlel
Sr,rbstance S-tored: Diesel /
Tank Materlal-lrlod: Asphall Coated or Bare Steel ' None
ATG: /
ATG Specs: / /
ATG Tert:
LTTTest:
Tank lIVAlt lD: 3 /3 (7655)
Slphon/Compart: No / No
Plpe Materlal-Mod: Galvanized Steel - Socondary Containment
Plpe Type/ISTP Cont: Pressurized / No
STP Flex Connectore : Steel Flox in Sump
LLD Mode|:
Splll/OverllllAlm dellv: 5 gal. Per Prod. APST Cont. Sump / none / No
PSIT FunilOther Type: Yos /
Tanlr/Plpe Rel [let: TrT/rc i LTT / NONE
Slphon/Compart: No / No
Tank Status: Currently ln Us€
Tank lilAlt lD: 414
Slphon/Compart: No /No
PWStagel: No
None
!L9rit_ _
EGen/ASTlStat No/Yes/
PWStagel: No
EGen/ASTlStat No /Yes I No
PWStagel:
Tank Status: CurrentlY ln Use Nons
lndalled/Cap/L*z 11111987 120720 / North
Subetance Stored: Gasoline / Regular
Tank Material-lr/lodr Asphalt Coatod or Bare Sleel - None
ATG: /
ATG Spece: i /
ATG Test:
- -LII"I- !?t"r-
-iG r,r"t-*iir-fr; E"rr-l; stJ--s-.."M&Zo.f"i.il.ii - -
Plpe Type/ISTP Cont: Pressurized I No
STP FIex Connectort: Steol Flex in Sump
LLD Model:
Splllr0verllllAim dellv: 5 gal. Per Prod. APST Cont. Sump I none / No
PIST Fundr0ther Type: Yes /
Tantr/Flpe Bel [let: TrT/rc i LTT / NONE
STP Sump Teet:
CP Tank Test:
STP slrmp Test:
CP Tank Test:
Splll Bk Tett:
Overllll Test:
CP Pipe Teet:
Spill Bk Test:
Overllll Test:
CP Plpe Test:
Tank Status: Cunently ln Use
lnotalledlCay'Loc: 1 11 11987 I 5615 I
Substanc€ Stored: Diesel i Oft-road Dissel
Tank Materlal-Mod: Asphalt Coatod or Bare Steel - None
-pGfr
"I"rii-iloi''E"-rrfr ,"4-st"iils-""o-noi-'v-co-nrf nileii--
Plpe Type/ISTP Cont: / No
STP Flex Connectorg: Sleel Flex in Sump
LLD Model:
deliv: / / No
Type: Noi
Page 1 of241812024
ATG: /TanlnPipe i OTHER /NONE
Utah Department of Environmental Quality - UST Release Detection
TANK OWNERSHIP
Name The Border Store
Address PO Box 2763
HILDALE, UT 84784
Contact The Border Store
Phone
Email borderstore2@gmail.com
TANK LOCATION
Name THE BORDER STORE, LLC
Address 625 N. STATE STREET
HILDALE, UT 84784
A Operator None
Phone None
B Operator SAME
Phone SAME
Facility ID: 6001029 Inspection Date: 04/23/2024
DISPENSER DETAILS
DISP
ID/ALT
ID
SUBSTANCE UDC PIPE FLEX LOC
INSTALL
DATE
UDC
INSTALL
DATE
FIRE
VALVE
SAT
PRESENT
UDC
TEST
DISP
FLEX
CP
TEST
1 - 1/2 Gas/Diesel Yes Steel Flex in Sump None None Yes No None None
2 - 3/4 Gas/Diesel Yes Steel Flex in Sump None None Yes No None None
3 - 5/6 Gas/Diesel Yes Steel Flex in Sump None None Yes No None None
4 - 7/8 Gas/Diesel Yes Steel Flex in Sump None None Yes No None None
TANK DETAILS
Tank ID/Alt ID 1 / 1 (6077)
E-Gen/AST No / Yes
Siphon/Compart No / No
Tank Status Currently In Use
Installed/Cap/Loc Jan. 1, 1987 / 20720 / South
Substance
Stored Gasoline / Premium
Tank Material-
Mod
Asphalt Coated or Bare Steel-
None
ATG /
LTT Test None
LLD Test None
Pipe Material-
Mod
Galvanized Steel / Secondary
Containment
Pipe type/STP
Cont Pressurized / No
STP Flex
Connectors Steel Flex in Sump
LLD Model
Spill/Overfill/Sm
Delivery
5 gal. Per Prod. APST Cont.
Sump / none / No
PST Fund/Other
Type Yes / None
Tank/Pipe Rel Det TankTightness
PipeLineTightness
CP Tank Test None
CP Pipe Test None
Tank ID/Alt ID 2 / 2 (7656)
E-Gen/AST No / Yes
Siphon/Compart No / No
Tank Status Currently In Use
Installed/Cap/Loc Jan. 1, 1987 / 20720 / Center
Substance
Stored Diesel /
Tank Material-
Mod
Asphalt Coated or Bare Steel-
None
ATG /
LTT Test None
LLD Test None
Pipe Material-
Mod
Galvanized Steel / Secondary
Containment
Pipe type/STP
Cont Pressurized / No
STP Flex
Connectors Steel Flex in Sump
LLD Model
Spill/Overfill/Sm
Delivery
5 gal. Per Prod. APST Cont.
Sump / none / No
PST Fund/Other
Type Yes / None
Tank/Pipe Rel Det TankTightness
PipeLineTightness
CP Tank Test None
CP Pipe Test None
2024-04-29 Page 1 of 5
Tank ID/Alt ID 3 / 3 (7655)
E-Gen/AST No / Yes
Siphon/Compart No / No
Tank Status Currently In Use
Installed/Cap/Loc Jan. 1, 1987 / 20720 / North
Substance
Stored Gasoline / Regular
Tank Material-
Mod
Asphalt Coated or Bare Steel-
None
ATG /
LTT Test None
LLD Test None
Pipe Material-
Mod
Galvanized Steel / Secondary
Containment
Pipe type/STP
Cont Pressurized / No
STP Flex
Connectors Steel Flex in Sump
LLD Model
Spill/Overfill/Sm
Delivery
5 gal. Per Prod. APST Cont.
Sump / none / No
PST Fund/Other
Type Yes / None
Tank/Pipe Rel Det TankTightness
PipeLineTightness
CP Tank Test None
CP Pipe Test None
INSPECTION COMMENTS
None
2024-04-29 Page 2 of 5
FACILITY RESPONSES
The above accurately represents the
facility's release detection records Yes
Financial Responsibility
Financial responsibility method is ok?Yes
TANK RESPONSES
Tank 1 (6077) Pressure Piping Leak Detection
Does the pressurized piping system
have a valid annual line tightness test
or valid monthly monitoring?
Yes
Tank 2 (7656) Spill/Overfill
Tank has a spill prevention device?Yes
Are you able to visually inspect the spill
containment bucket(s) for functionality?
(i.e. are the buckets clean enough to
see cracks, etc?)
Yes
Is the spill containment bucket intact?Yes
Is the spill containment bucket(s) able
to contain a spill? (i.e. is there water,
product, debris, etc in the spill bucket
to prevent it from containing a spill?)
No
Tank 2 (7656) Spill/Overfill
Does the spill bucket have a valid 3-
year test, valid monthly monitoring for
DW buckets, or the tank is exempt?
Yes
Tank 3 (7655) Pressure Piping Leak Detection
Does the pressurized piping system
have a valid annual line tightness test
or valid monthly monitoring?
Yes
Tank 1 (6077) Spill/Overfill
Tank has a spill prevention device?Yes
Are you able to visually inspect the spill
containment bucket(s) for functionality?
(i.e. are the buckets clean enough to
see cracks, etc?)
Yes
Is the spill containment bucket intact?Yes
Is the spill containment bucket(s) able
to contain a spill? (i.e. is there water,
product, debris, etc in the spill bucket
to prevent it from containing a spill?)
No
Tank 1 (6077) Spill/Overfill
Does the spill bucket have a valid 3-
year test, valid monthly monitoring for
DW buckets, or the tank is exempt?
Yes
Tank 2 (7656) Pressure Piping Leak Detection
Does the pressurized piping system
have a valid annual line tightness test
or valid monthly monitoring?
Yes
Tank 3 (7655) Spill/Overfill
Tank has a spill prevention device?Yes
Are you able to visually inspect the spill
containment bucket(s) for functionality?
(i.e. are the buckets clean enough to
see cracks, etc?)
Yes
Is the spill containment bucket intact?Yes
Is the spill containment bucket(s) able
to contain a spill? (i.e. is there water,
product, debris, etc in the spill bucket
to prevent it from containing a spill?)
No
Tank 3 (7655) Spill/Overfill
Does the spill bucket have a valid 3-
year test, valid monthly monitoring for
DW buckets, or the tank is exempt?
Yes
DISPENSER RESPONSES
2024-04-29 Page 3 of 5
Dispenser 3/4
Fire valve is anchored properly?Yes
Does the line tightness test port on the
fire valve have the manufacturers plug
installed in it? (no ball valves)
Yes
Is the fire valve located properly below
grade?Yes
Is the fire valve's fuseable link intact?Yes
Dispenser 7/8
Fire valve is anchored properly?Yes
Does the line tightness test port on the
fire valve have the manufacturers plug
installed in it? (no ball valves)
Yes
Is the fire valve located properly below
grade?Yes
Is the fire valve's fuseable link intact?Yes
Dispenser 1/2
Fire valve is anchored properly?Yes
Does the line tightness test port on the
fire valve have the manufacturers plug
installed in it? (no ball valves)
Yes
Is the fire valve located properly below
grade?Yes
Is the fire valve's fuseable link intact?Yes
Dispenser 5/6
Fire valve is anchored properly?Yes
Does the line tightness test port on the
fire valve have the manufacturers plug
installed in it? (no ball valves)
Yes
Is the fire valve located properly below
grade?Yes
Is the fire valve's fuseable link intact?Yes
MONTHLY LEAK DETECTION MONITORING
Apr '23 May '23 Jun '23 Jul '23 Aug '23 Sep '23 Oct '23 Nov '23 Dec '23 Jan '24 Feb '24 Mar '24
Tank 1 Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
Line Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
Tank 2 Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
Line Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
Tank 3 Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
Line Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl Not Appl
NON-COMPLIANCE ITEMS
TANK 1 (6077)
Question:Is the spill containment bucket(s) able to contain a spill? (i.e. is there water, product, debris, etc in
the spill bucket to prevent it from containing a spill?)
Comments:remove liquid
TANK 2 (7656)
Question:Is the spill containment bucket(s) able to contain a spill? (i.e. is there water, product, debris, etc in
the spill bucket to prevent it from containing a spill?)
Comments:remove liquid
TANK 3 (7655)
2024-04-29 Page 4 of 5
Prepared by fueloperator.com
Question:Is the spill containment bucket(s) able to contain a spill? (i.e. is there water, product, debris, etc in
the spill bucket to prevent it from containing a spill?)
Comments:remove liquid
Inspection Information
Inspector:Saathoff, Rick
Record Created:April 29, 2024, 6:48 a.m.
Inspection Date:April 23, 2024
2024-04-29 Page 5 of 5