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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 ol,Lr,) J,/ h,,k / /rr)? o/ oL,* /ca,n) /- ,/t/ ,'rt rozLl 5o)/. t/t laL ),l",bt- ot piil,? , rrrt/ar[ u0c- lrnttl,f//L- 4o L 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