HomeMy WebLinkAboutDERR-2024-006455\
Owner Name: WIMMER ELECTRIC & LIGHTING CO
OwnerAddress: 5330 S RILEY LN
Underground Storage Tank lnspection Verification Form
'1/q/ t f z Pn Facirity tD: 4oo1z7e
lfo iltA,.--(
1 MURRAY UT 84107\
Operator A: \llELVIN BOHNKE (801) 262-8780
Owner Email: wimmerelectric@earthlink.net
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Facility Name: WIMMER ELECTRIC & LIGHTING CO.
Gtreet Address: 5330 S RILEY LN ( 200 W )
\4URRAY UT 84107
Operator B: MELVIN BOHNKE (801) 262-8780
UTM Coordinates X/Y: 424153 I 4500804 Hand Held GPS with Base
Tank lD/Alt lD:
Manif/ComparUAST:
Tank Status:
lnstalled/Cap/Loc:
Substance Stored:
Tank Material:
Tank Modificationsr
ATG:
ATG Specs:
313 E-Gen: No
No No No
Currentlv ln Use.
7---
9/11/1998 (_toog-) Single
-_-
Gasoline Regular
Galvanic Cathodic Protection (STlP3)/
None
Pipe Material: Bare Steel/
Pipe Modifications: Cathodically Protected
Pipe Flex Connectors:
Pipe Type: Safe Suction LLD Model:
Spill/Overfill/Sm deliv: 5 gal. Spill Buck Ball float valve No
Sump Cont: No Disp Cont: No
PSTFund: Yes OtherType:
TanUPipe Rel Det: SIR OTHER NONE
- ltD{^l )r<
TTf:. 512412010 LTT: 8/1'l12005 LLD
,.
CP Tank: 9l1Ol2O13' CP Pipe: gl1)l2}fi<
{ l,tt/s fo, )r( ". <t/o'f at.
S/;il B .uKl eKLo l/" n? .
Zf/ f^Vo-.rt/1 fl//
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4t8t2014 Page 1 of 1
Underground St]age Tank lnspection I erif ication Form
Owner Name: WIMMER ELECTRIC & LIGHTING CO
OwnerAddress: 5330 S RILEY LN
MURRAY UT 84107
Owner Contact: GARY WIMMER (801) 262-8780
Owner Email:
Facility lD: 4001279
Facility Name: WIMMER ELECTRIC & LIGHTING CO.
StreetAddress: 5330S RILEYLN (200W )
MURBAY UT 84107
Facility Gontact: GARY WIMMER
UTM Coordinates )UY: 424152.544363777 I 45 Hand Held GPS with Base
Tank lD/Alt lD:
Manif/ComparUAST:
Tank Status:
lnstalled/Cap/Loc:
Substance Stored:
Tank Material:
Tank Modifications:
ATG:
ATG Specs:
3/3
No
Currently ln
9/1 1/1 998
Gasoline
E-Gen: No
NoNo
Pipe Material: Bare Steel
Pipe Modifications: Cathodically Protected
Pipe Flex Connectors:
eiP'rvnqf@!1@ LLDModerr
Spill/Overfill/Sm deliviS gal. Sriiit Auck Ball ftoat vatve" No
Sump Cont: No Disp Cont: No
PST
Use
Single
lar
Galvanic Cathodic Prolection (STlP3)
None
TanldPipe
Other Type:
OTHER NONE
4000
o TfT: 512412010 Lfi: U11l2005 LLD:CP Tank: ,,n,rl'r| J CP Pipe: 7/gt2o1o
Zrt b
/o
VK
PVT
6 lLq
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\trlI+\le townerName W i
Tank 2 k4
1/Address E
UT
Phone
of tanks at the
3 t,
State
PhoneContact
qTank lnstallation Date 4kCapacity of Tank (in qallons)
lndicate if tank is siphoned or cotrpe[4enleO.Show related tanks.
/-a 3Substance Stored
deG) No Yes No Yes No Yes NoTank is in use.
lf not in use. oive date last used and depth of product in tank.
Yes No Yes No Yes No Yes NoCurrent year tank taqs are in place.
34,^rt 3Material of construction of tanks tMaterial of construction of piping
*4 vCre Suet *t'o nPipinq type
LType of Spill Prevention device
Yes NoSoill containment bucket is intact, clean, and free of product, water, debris.No Yes No Yes No
R; tl €?t ILType of Overfill Prevention device
Yes tto 16Overfill alarm (audible or visible) is properly located so delivery driver can hear or see it, and is clearly identified
Yes No ffi>Containment sumps are sealed, free from water, product, etc.
6 ruo N/AThe results of the last two cathodic protection tests are available (within six months of installation and every three years thereafter).
Tester UTCathodic Protection Testing. Date of last test: I O - Ll 'g 6
lmpressed Current System is checked for proper operation at least every
60 davs and the results of the last three checks are available.Yes No (D Dates of last three checks:
lmpressed CurrentSacrificial
Anode lnstant Off Depolarized
Corr. Protect.
Method
1 5tL
2
3
Tanks
4
1 1A
2
3
Lines
4
1
2
3
Tank
Flex
4
Disp.
Flex
lndicate below the corrosion protection method in place for each UST system component. ldentify each dispenser by pump numbe(s). Show readings
for the most recent cathodic
North
Comments
I 2l
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Tank 3(rkl)
Sionature: .6-znnz,/1^ /n rlnfr-
Method used for tanks:k Testi Statistical I Reconcillation M k
SIRY TrT/ LTT 3rd
the last
Yes No
Circle
SIR
or No for
used:
IC SIR
lnventory readings for product inputs, withdrawals, and the amount
remaininq in the tank are recorded and available for each operatinq dav.No@
MTG
Records show proper sticking and measuring of product level at beginning
and end of inactive period of appropriate lenqth.Yes No lnactive period 36 44 58 hrs.
IC SIR
Product inputs are reconciled with delivery receipts by measurement of the
tank inventory volume before and after deliveries.@*o
IC SIR MTG
lnventory readings are properly reconciled monthly (weekly and monthly
for MTG) to the appropriate allowable amount.No(6
No@
IC SIR MTG
Equipment used to take readings (ATG, Gauge Stick, etc.) is adequate,
accessible, and operational. lf ATG is used, system has proper
documentation of setup, calibration, etc., and owner's manual is present.Type used: 11,,LL
No@IC SIR MTG
An appropriate calibration chart is used to convert product level readings
to gallons, and is available for review.
\@ ruoIC SIR MTG
Documentation of valid testing or monitoring is available for the last 12
months. Show results in table below.
fO ruoIC SIR
Records include the appropriate number of water readings, and water
readings are used to adjust inventory balances as necessary.
No@ Calibration date:I oIC SIR
Dispensers have current calibration stickers or proper calibration
documentation.
@NoIC SIR
Drop tubes are present and extend to within one foot of the tank bottom.
6 ai,D
tank for
indicate whether the
Mo/Yr <,
#I P
#
#
#
Tank Tiqhtness Testing Tank 1 Tank 2 Tank 3 Tank 4
Results of last tank tightness test are available:&1 N Results:Pa s<
Test Date 8-ltaS Tester name and cert. number:UT Test Method
PIPING LEAK DETECTION
Method(s) Used (Automatic line leak detector and one other method are required for Pressurized Piping):
[ ] Automatic Line Leak Detector t I Line Tightness Testing [ ] lnterstitial Monitoring Type of lM Documentation
Statistical lnve Reconciliation Groundwater .2 GPH
Documentation is available and verifiable to show that piping operates at less than atmospheric pressure, has only one check
valve (under pump), and has proper slope of piping.NoYes
Safe Suction Piping
Tank 4Tank1q. LiLine fueResults of last line tightness test are available: ''*ResultsN
lesleg1slFff'Tester name and cert. number:UT Test Method
MES MESMESMESType (M- Mechanical E- Electronic S- Sump SensoQ:
Manufacturer and model of each leak detector:
Automatic Line Leak
Detectors
Results of last leak detector performance test are ava!!qb!e: Y N Results
Tester name and cert. number:Test date:UT Test Method:
theresults of
Mol/r
#
#
#
#
COMMENTS
D6tribution: White- DERR, Yellow-lnspector, Pink- Facility/oMer
Utah .,ST ProgramControl SIR Manual Tank
h@L\n
of
Show results of monitoring
3/o=*/.2 6/-z 7/a zqtto/rt t\/ot
\-.-
Tank 2 Tank 3
for
Ldicimtg0604.doc
JON M. HU\ .AN, JR.
Govemor
GARY HERBERT
Lieutenant Governor
State of Iltah
Department of
Environmental Quality
Dianne R. Nielson, Ph.D.
Executive Director
DIVISION OF ENVIRONMENTAL
RESPONSE AND REMEDIATION
Brad T Johnson
Director
August 31,2006
To:Gary Wimmer
Wimmer Electric & Lighting Co
5330 S Riley Ln
Murray, UT 84107
Re Non-compliance of underground storage tank at Wimmer Electric Lighting Co, 5330
South Riley Lane, Murrah, Utah.
Facility Identification No. 400127 9
The Utah Underground Storage Tank Act (ACT) provides that the Executive Secretary (UST)
may revoke a Certificate of Compliance, if it is determined, that a facility is not in substantial
compliance with all state and federal UST statutes, rules, and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and
Remediation (DERR) performed a compliance review for the underground storage tanks (USTs) at
the above facility. The compliance review, performed on June 14, 2006, indicates you have not
satisfied the requirements of the Act and are out of compliance. To achieve compliance, you must do
the following:
Submit documentation to show that cathodic protection system associated with the
product piping is functioning properly (Note: The cathodic protection test of
08/11/05 indicated the product piping is not cathodically protected).
2 Submit evidence that proper Inventory Control/Statistical Inventory Reconciliation
(SR) is performed on UST #1 by:
a Documenting that the water in each UST is measured to within one-eighth
inch, at least once per month, and the water measurements (converted to
gallons) are used to correct the monthly inventory re-conciliations.
Documenting that you meter the product withdrawals and maintain the
dispensers to a calibration accuracy of six cubic inches for every five
gallons of product withdrawn.
168 North 1950 west . PO Box 1M840 . Salt kke City, UT 841 14-4840. phone (801) 536-4100 . fax (801) 359-8853
T.D.D. (801) 536-4414 . www.deq.utah.gov
I
b.
^1
- Page2
The above information must be submitted to this office by September 30, 2006. If you fail to
submit the required documentation as requested, you will be charged $70.00 per hour for time
and travel as allowed by statute, for every follow up inspection necessary to document
compliance. If you have questions concerning this matter or need any assistance, please contact Paul
Harding at (801) 536-4108.
bvuqtt9t
owner Name wtMMER ELECTRTC & LtGHTtNG CO Location N16ms WIMMER ELECTRIC & LIGHTING CO
5330 S RILEY LNAddress Address 5330 S RILEY LN ( 200 W )
City MURRAY stateUT zip 84107 6;ry MURRAY State UT Zip 841O7
Phone (801) 262-8780Contact cnnv WIMMER Contact cenv WIMMER Phone
Comolete for each tank. lf the facilitv has more than four tanks. cor 0rm.
Number of tanks at the facility:
Tank lnstallation Date 9/1 1/1 998
CapaciU of Tank (in qallons)4UUU
lndicate if tank is siphoned or compartmented. Show related tanks.
Substance Stored
gasolna negutar
Sinnlo
Tank is in use.Currently ln Use Yes No Yes No Yes No
ll not in use, oive date last used and depth of product in tank.
Current year tank tags are in place,(%b, No Yes No Yes No Yes No
Material of construction of tanks Galvanic Calhodic Pro
Material ol construction of piping
Pipinq type Safo Suctinn
Tvpe of Spill Prevention device W q-u"t
Spill containment bucket is intact, clean, and free of product, water, debris.dq No Yes No Yes No Yes No
Tvpe 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 lC/A
Containment sumps are sealed, free from water, product, etc.
.:Yes ruo (rulA
The results of the last two cathodic protection tests are available (within six months of installation and every three years thereafteo.J'Ye3 No N/A{lttlo{Cathodic Protection Testinq. Date of last test Tester tr ta(
lmpressed Cunent System is checked for proper operation at least every
60 davs and the results of the last three checks are available.Yesy'o N/A Dates of last three checks: z/
lmpressed CurrentCorr. Protect.
Method
Sacrilicial
Anode lnstant Off Depolarized
1 cp >-1t 0l
2
3
Tanks
4
1 cp QA'4a I
2
3
Lines
4
1
2
3
Tank
Flex
4
Disp.
Flex
lndicate below the corrosion protection methods in place lor all UST system components. ldentify each dispenser by pump numbe(s). Show readings
for the most test.
SrIe Urawrng Nonn
Comments
I L I th
v
J,
Name of il,"1{+lrr+hr,, Sil nAAr ti<-v
S
Ldcheck1205.de
ete lhe information
T---3------:r-1
TTT/I.C.
Method used for tanks:Tank Control Statistical Reconciliation
PIPING LEAK DETECTI OTHER
and one other method are required for Pressurized Piping)Method(s) Used (Automatic
[ ] Automatic Line Leak Detector [ ] Line Tightness Testing [ ] lnterstitial Monitoring Type of lM Documentation
Reconciliation Groundwater Mon ,2G T
Tank
5/06
Vto6o,),t1+{.-pfess
SIF/ rrT/ LTT 3rd certification available Yes No
)c srn
lnventory readings lor product inputs, withdrawals, and the amount
remaininq in the tank are recorded and available for each operatinq dav No@
MTG
Records show proper sticking and measuring of product level at beginning
and end of inactive period of appropriate length.NoY lnactive period 36 44 58 hrs.
IC SIR
Product inputs are reconciled with delivery receipts by measurement ol the
tank inventory volume before and after deliveries.)*o
IC SIR MTG
lnventory readings are properly reconciled monthly (weekly and monthly
lor MTG) to the appropriate allowable amount.No(",7
IC SIR MTG
Equipment used to take readings (ATG, Gauge Stick, etc.) is adequate,
accessible, and operational. lf ATG is used, system has proper
documentation of setup, calibration, etc., and owner's manual is present.
Noe 5l;-QType used:
@NoIC SIR MTG
An appropriate calibration chart is used to convert product level readings
to qallons, and is available for review.
GNOIC SIR MTG
Documentation of valid testing or monitoring is available for the last 12
months. Show results in table below.
Yes @tc stR
Records include the appropriate number of water readings, and water
readinos are used to adiust inventory balances as necessary.
ves @ Calibration date:IC SIR
Dispensers have current calibration stickers or proper calibration
documentation.
3/06 4106
rn oneDrop tubes are present and exend toIC SIR
1 1/05 1/0610/05Mol/r
tan No
12t05 u0671058/05 9/05
o Ppppp#I P
#
#
Q,sStest are available:Results of
#
Results:tank N
Test 3UTIz(ula{,\"T Tester name and cert. n
Documentation is available and verifiable to show that piping operates at less than atmospheric pressure, has only one check
valve (under pump), and has proper slope of piping.No
Sale Suction Piping:
Yes
tess Testin r. Line l-e - Tank
Results of last line tiqhtness test are available: Y N Results
Test MethodTest Date Tester name and cert. number:UT
MES MES MES MESType (M- Mechanical E- Electronic S- Sump Sensor)
Manufacturer and model of each leak detector:
Results of last leak detector performance test are available: Y N Results
Tester name and cert. number: UT Test Method:Test date:
rinn fnr ninir rt 12 mnnth i. lndicaterg for the la
MoIYr
#
#
#
#
COMMENTS
^,
'loo ttt l
EXPIRATION DATE:,)
> Access to the soil directly over the cathodically protected structure that is being evaluated must be provided.
) A site drawing depicting the UST cathodic protection system and all reference eleclrode placements must be completed
I
!I. UST FACILITYI. UST OWNER
tLi /31lo,NAMENAMEl),)*e, f /t,/r,L'? /',tl/i ;a &
Sss oAOORE9S5:3o 9"{t,i',t", uL, 'ADORESS:
&// taL<-COUNW:srarc: t4l cnt y')/fUfzottCIW:)'4vt(aa
rvlcP f ESrER's euALtFtcATtoNs' ut. cP TESTER
A.+a-zTESTER'S NAHE:
COilPAilY NilTE
ADORESS:PHONE NUMBER:tra/-5/?-Z?ostere: /1/"tn' (a;$rri/lo
E Routine - 3 year ! Routine - wthin 6 months of installation ,yla-l/-r'7
tr
hereaner)
Re-survey aner repair/modinc€tion90-day re-survey afrer fail
(rBquired vvithin 6 rnonths of installatiorvrepatr & etery 3 yearsOate nei cathodrc protecllcn sun€y must be cooducied by
Vl. CATHODTC PROTECTION TESTEB'S B/ALUATION r'-.t""r,
All protected struclures at this tacility pass the cathodic proteclion survey and it is ludged that adequate catho<tic prolection has
been provided to the UST syslem (indicate all criteria applic€ble by completion of Section Vlll)
EA |l One or more protected structures at this facility fail the cathodic protection Survey and it is judged that adequate cathodicI ^rL proteclion has not been provided to the UST system (complele Section lX).
tl the romote and the local do not both indicate lhe same test resull on all protected struclures (both pass or both fail)
PASSE
n rNcolrcLUslvE be evaluated and/or conducted by a corrosion expert (complete Section Vll),nconclusive is indiqatqd and tfr$urveflls
D^rE cP suRvEY PERFoRMED: /O - //- J hCP TESTER'S SIGNA
fOSION EXPERT'S EVALUATION t'n * oory one)/ "/ vlt. coR
by a conoson experl when: a) an incorclusire is inclicated br any protected stnrcture snce bolh the local and he
Itho samo oulcorne (both pass or both hil); b) repairs to galvanrzod or un@ted steel pitrr€ are cooduoed o( c)
ErpplemenEl anodes are add€d to Ulo tranks andor frFrng witftout bllo,Ying an accepted induggy coqg:
evaluatedThe EJn€y must b€
rBmob smrcturlDsdt potentials dc not r6ult in
All protected structures at this facility pass the cathodic proteclion survey and it is iudged thst adequate cathodic protection has
been provided to the UST system (indicate all crileria applicable by completion of Section Vlll). \ --
One or more protecled structures at this tacility fail the cathodic proteclion survey and il is judged that adequate cathodrc
proteclion has not been provided to the UST system (indicate what action is necessary by complelion of Seclion lX)
PASS
FAIL
tr
tr
COTIPANY XATIE:CORROSIOTI EXPERT'S NAME
ITACE INTERXANONAL CERNFEATION NUMBER :XACE INTERXATIONAL CERNFICATION:
CORRqSloN EXPERTE SIGNATURE:
Vll l. CRITERIA APPLICABLE TO EJALUATION (mrrt .rr th.t .ppry)
SuucturFtosoil potential more negative than -850 mV with resp€cl to a Cr/CuSOr refErenca electrocre wrth tr|e proteclve
W 850 ON oJrrent appli€d (This critenon is applicable to any galvanlcally protected struclure).
Sfucturltogoil potential more negative than -850 mV with resp€cl to a Cur/CuSOr reteren@ oledrode wth proleove cunent
850 OFF temporarily interrupted (This criterion is applicabl€ only to ttros€ galvanic systems where the anodes can b€ disconnecled)
Structure testsd exhibits at least 100 mV of cathodic polanzatron (This qiterion is apdrcable lo galvanrc systems where the
mV POIIRIZATION anodes can be temporanly disconnecled).l-l '*
lX. ACTION REQUIREO AS A RESULT OF THIS EVALUATION (rn rt onry on.)
NONE Cathodic proteciion is adequate. No further aciion is neoessary al this time. Test again by no lsler than (se€ Section V).
RETEST Cathoctic proteclion may not be adequate. Retest during the next 90 days to determine if passing resutls can b€ achreved
REPAIR E RETEST Cathodic proteclion is not adequate. Repair/modification is necessary as soon as practical bul within the nexl 90 days
n
tr
GALVANTC (SACR|FICIAL ANODE) CATHODTC PROTECTION SYSTEM EVALUATION
titlh l)[Q linrtcrgroirnrl litrrrirgc T:rnk lDrogmnt ,
OATE:
No\/ 0 I 2006
DEQ
lnvuonmenlal Blsgonse & Bemedtalton
'/
cP TESTERS cERrlFlcAnoN xu*taeR: /.1 / D / / b
V. REASON SURVEY WAS CONDUCTED ('n rtonrvo{o)
\
PIPING FLEX CONNECTORSTANK 'PRODUCT CAPACITY TANKS
{4:B /Jr.*,1 ru4* /, l/h11o,,./,-/,trao
2
3
4
5
6
7
I
9
10
CATHODIC PROTECTION AND'OR MODIFICATION :] ;
Cr.nplde il 8ny rep8ir! or rnodificationg to the c€thodic protection systom are madg gr arB nBcessary, Certain rep€irc/rnodifications ero r€quired tc bo deegned
andor e\€luated by a conosion operl (cornpletion of Section Vll roquired).
Supplernental anodeg tor a sti-Pr'tank (an8ch conosion export's clesign or docum€nuon lndustry standard was follo\ ,€d).
X Supplennntal anodes for metallic pip€ (attach conosion exp€rt's design or documention lndustry standard was follouod)
tr Galvanically protected tsnks/piping not electricslly isolated (explain in "Remarks/Other'below)
-(-Lu, I +a-t-Rernark9Other:
/,;-
or uso tho spsca to a th€sy9tsrTls.must tc
irK,icsto wh€re th€d€ctrod€ was placed br cscfl sEuduretosorl potsntiel hst is r€corded on thg suNsy torme. Any p€rtinent data rnr.i also b€
indudod. At e dnimum yol shonld indk=te tho bllowing: Al tankl, prprng and c,Bpons€rs; Al buildings 8nd $e6; All snodos and wirBs; Locatbn d CP test
deti6s; Eadr rslbrqlcs electrorto plaenrent mud bo indicstod by s cod€ (1 ,2, T-1,) con$ponding with tho app.opriato line rumber in S€ction XIV of this forrn.
AN B/ALUATION OF THE CATHOOIC PROTECTION SYSTEM IS NOT COMPLETE AN ACCEPTABLE SITE DRAWNG
Shry
N
i, /l
I7*y
This section may be utilized to conducl a survsy of a galvanic cathodic proteclron system by obtaining struch.rEtlsoil potential rneasurernents.
The relerence eleclrode must be placed in ttre soil directty over the teeted structure (local) log 2t100 bet away from the Structure (remote)'
Both the local and the remote voltage must be 450 mV or more negative, in order for the struciure to pass.
lncondusive i9 indicaled vvhen both lhe local 8nd the remote structure-|g-ltqil potentisls do not resull in the same oulcome (both gass or both fail).
lz,NOTE: Iho turvay ir not complole unlelr all opplicablr pan! gl !€dlm3 I - XIV eo 6lso corploldFACIUTY XATE
O€ECruA€ LOCAIX'T{ OF RET'OTE RETEREilCE ELECTROOE PlrCETET{T:
LOCAL
voLTlcE
REMOTE
voLTlcE'
PAS!,fAJU'
ll{COiaCLUstlrtCOT{TACT POINT I ,
LOCAL REFERENCE CELL PLACEMEilT.Loclnox'
cooE STRUCTURE t
i.jtt,t!, 1(axattdo) 1.r r;i-r;l.rTANK BOTTOM ,;lfi*1+ii;[91'fli+,lmr
-'*, (axrmpl€) ;
:]r;.1.1i :928 &-"
.i(6xarnPle)
,ir: €10 j '
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D{@NCLUEVE
,..,.- .. .i:.i,:, -/, ii:, (€XArndC) l:ft,r;'.i!;a:1.,J.' r'.,r,? ;-i'r'i-
.ir:,i;,:r r:'- pL S TANK STp MANINAYri,Y,i'i.li ::,rr.(oergc)..
i.'iti';1+J:{:r
.::.(€xanple)
i'j,rj,r.l885 :ri:,
::. (exarg.).r..:;:r:p[$$,.'i',i:.::i ...i,:i,:t-,'r; Ir:\il:'(qflDplo)r;iti.ii,.!;'1;'".-;(t:',i.ri.i'r
:'i':-..--1 '. UNDER DISPENSER tr6 :il,:.1 ".rI .r
,.: (€xrmplo):.;.:1
i;r;..:€90 .r'rli,:,
E,E+-l(;ffii-ft-B'!ai;:r PLU S Pt Pl NG ilfl&ii
ri:_,r..:',i!1r!.i! (CxarqilO) i ilrj: :::ri.
.}di' P1SP91195R 5r€'d':'
-,/il f -/ta /?,, ,E,k^lZ*r,&o,r.4zr7/bndn';a,lb,/to,/rrl T^L I
-/?ao -///a P.n=P,/r-hLo(D/s "n^sf.//r,/t, h,*'@rt{rI7
COt{HENTS:
1 OGsgnate numencally or by code on the site dra,t ing each 'local' reterence eledrod€ plaern€nt (e.9. 1 ,2,3,.. T-1, T-2, P-l, P-2... etc.).
2 Describe sle structur€ that is b€ing tested (e.9. plus tank; prenaum prping; dieset submersible pump flex connectoi etc.).
3 Oescribo wlrero @fltact with the srucure that is being tested is made (e.9. plus lank @ test lead; diesel piFnrE @ dispenser 5/6; tank test lesd: pp4, etc)
4 Oescribe trl€ e)6ct location where reference elecltodo is placed for eacfi'local' rneasurement (e.9, scil @ plus tank STP; soil @ dispenser 5/6, erc )
5 Record tr|€ sfudurE-tGsorl potential measured wth the rebrence elecfode placsd'l€al'in milli\olts (e.g -€65 mV, .920 mV. etc.)
6 Record th€ stsuGuretosoil potential rneasured wrth rle rebrence elecfodo placed'rernote' (copy voltage that was obtainod dunng continuity 3un€y).
7 lndicatG wh€thor the testsd strrrturE pass€d or tailod t|e {50 mV 'on'cfltorion bas€d on your interprotstbn of th€ t6st ctata.
xtv. GALVANTC (sAcRrFrcrAL ANoDE) CATHODIC PROTECTION SYSTEM SURVEY
,
tank Arlhat protectioncatpdic Systems.rnoasurqr€ntgcondud ol on stofag€systems byprobcteds€ctbflThis be !o continurty undergroundlJtilizodrnay
loc8tionrernote leftand urdisturbec,atelecfod€reference b€must tn soilthe afixodacollft€plac€dWh,sl gIoUndmoving surwyoonducting
incondusiv€is indi€tosorbrsttudureshewhicfrlixed continuitypossrbleCorxructb€'ni€€arbst two cell-moving slJrvoygru.rndpcint-Epcint 8ny
tflernelallicoth€r instrlrciure toorderb€must tromisdatedtlattoisb€th€structureFor
NOTE: The sumy ir nol complot€ unlsss Ell apPlicablo gans ol Sodion! l-xlv aro deFAcrurY *'' /), n: n, Elr-/r,"
O€SCEBE LOCATIOI{ Of'fUEO REI.OTE' REFERENCE ELECTRODE PLACETENT:
POTXT.TO+OrNT
VOLT^GE
OIFFERENCE
rsouTEcv
coxIlr{uous,
It{coxcLUslvE
grauctuae 'a''
FUEO REIrcTE
VOLTAGE
STRUCN'RE'A'I
FIXED RErcTE
VOLTAOE
STRUCTURE "8",
;1,ilsi.i(0.ntCa).#iii:' I tu#tt{921'6yd',wll
Jriti,1l.:(ocrPa.) is I
,' :i,:,ilt' :17 mV,.r'. ;
, -,t-;, lrxrnpr) t;.",. ISOI.ATED,:;,'.+rl.$t$ml',1ffi,'lll:!*zr?*i3fa!1t r (o(anpte! :;13ri; ;+1'r
}ffi PREMIUM TANK FILLRIS
(t
COIUEXTS:
taprem nk).strucluresisolatedrs (e .sfromdemonstrateunprotecledtothatattemptingarestrudureyoutheD€scrib€1 cathodically protecled
fiilkretan riser)the structuisolatedtsfrom (e.g premiumdemonstrateprotectedtothatar€lstruclurB attemptingOescrib€2 Uthe younprotected
millivoltstn -921structure(e mv).theof cathod rA1icallyprotectedstructure-to-soilRecord3 potentialrn€asuredthe
1millivolts-9 5restruclutn mV).theof (e g.utial nprotected rB')strudure.to-soilRecord4meSsurgd potenth€
71 mU@when(egstruclurespoint-tofointnducting tastingtheandthebetweenunprotecledobservedprotectedRecord5th6voltageinconclusiverocontinuousw8sstructureisolatedtheindicatedtoand/oraellthewhethertestDocument6
xil. cALvANtc (sAcRtFtctAL ANoDE) CATHODTC PROTECTION SYSTEM CONTINUITY SURVEY
STRUCTURE "A" t
WINNEI ELECETIC
€ LIG}EITG CO, IIIC.
5330 RILEY LANE, MURRAY UT 84107 O Phone (801) 262-8780
NOVEMBER 7,2006
TO:MR, PAUL HARDING
RE: UNDERGROTIND STORAGE TANK
RECEIVED
Nov 0 I 2006
DEQ
Enttironmentai Response & tlemedration
I HAVE ENCLOSED A COPY OF THE CATHODIC PROTECTION EVALUATION FROM
SPACKMAN ENTERPRISES. THEY MADE THE NECESSARY REPAIRS TO THE TANK AND
IT PASSED THIS TIME. I AM STILL WORKING ON THE CALIBRATION BUCKET
ISSUE. I WILL KEEP YOU UPDATED! THANK YOU FOR YOUR PATIENCE - WE WILL GET
THIS WRAPPED UP AS SOON AS POSSIBLE!!
HEATHER SUNDQUIST
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FAC'UTY XAXE:
D€8CR'3E LOC
'IOT'
OF R.EuC)TE REFERATCI EUCTROO€ PLACEIEI.'r:6/
LOCATIOXt
cooE
"iffit1fiii:
STRUCTURE I CONTACT POINT !
r.rc;ffitT.,..*;i:}: TANK BOTTOM :i?,
LOCAL REFERENCE CELL PLACEMENT.LOCAL REMOTE
(u8rg€) :
I )SltCLLrEJ!€
i ilf. i,-rt (ox&nd6) i:,)t::1 :liil.
i$i DIS PE NS ER'5/13,.i]'i
.. (er8rd€)
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P,/u,lthr(Drr rr.n<.,r.t/r.,/t, h,i,Eo{J^z -/1oo -///o7
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COHHENTS:
xlv. GALVANIC (sAcRrFrcrAL ANoDEI CATHODIC PROTECTTON SYSTEM SURVEY
Nov 07 OG O3:1?p lJimmer Electric p.1
This s€clion may be utillzed to conducl a survey of a galvanic cathodic proteclion syrtem by obtBining strudur+to.soll polentjal rneasuremenls.
Th€ relerence electrode mwt be placed in th€ soil directty ovar the tested struciure (loca0 BlLd 2$100 feel away hom lhe structure (remote).
Bor! the local 8nd tha remole vollagc must b€ -€50 mV or more negatlve, in order for the srudure to pass.
lhe
NOrE: fh6 wmy lt nol Erplstr unloa! alt rppllc.Dta pIl! gt r€dmJ I - xtv sr sts 6rpq6d
IXCOn CLUSIW
/to
Oesignate nurrEricalty or by code on the site draf,irE oacfr 'lcl'reforence etedrcde placement (e.9. 1 1, T-2, P.1, P-2...etc.).Describe the st uctur€ that is being tested (e.g. plus tanki prenium piprng; diesd subrnersibte trrmp ltex oonnectoq 6tc.).Oescrib€ yfiere contacl wifi the structuro thal is being tested is made (e.9, dus tank @ test lead; dies€l piprng @ dispenser 5/6: lank tesr te€o PP4 EtE)Oessibe the er€cl locatlon where relerene €leclrodo is placed lor eactr 'local' rn€esurament (6.9. rcil @ plr:s tank STp: soit @ djspenser 5/6 elc )Rffia !l€ structure.to-s.it potefltial measurEd wi$r the rebronce stectrode ptaced.teer in milli\o[s (e.g. {65 mV. .g20 mV, etc )Re@rd tl€ struclure.to-scil potential rn€asured wrth h€ relererice eleclroclo placed'rernote' (copy \ioltag6 that was obtainft dunno @nlrnurry
80 1 26287S 1
la
1
1
3
4
(
5
7 lndk=tG whtrlg. the lestod of tfE +50 mv o, thc tGst @ta.
3un€y)
h
r2 )
Nov O'7 OE O3: 1 7p l.rJimmer Electric 80 1 262879 1 p.2
NOTE Tho &my is rcl €anpbto unteta dl !g9li@ob pan! ol Soqions Lxlv ry6 at$
D€SCE]BE LOCATIOi OT 'FIXED RET'OfE' REFCREHCE ELECTROOE PI.ACEIIENT
I5OLI'TEry
COHTINUOUSJ
rrcoNcL uslvE
COTIIEXTS:
1 Describ€ the cathodically protecled structurB that you are attempting to domonstrale is isolated from unprotected structur€s (e.g.prem lank).2 Oescribe th€ unproloctd structurB thal you are attempting lo demonstrate is isolated from the protected structure (e.g. premium tank filt nser)3 Record th€ measured structureto.soil potential of the cathodically protecled structuro fA') in millivolts (o.g. -921 mV)4 Record the measured struclure.to-soil potantial of the unprotectgd structure fBJ in millivotls (e.g. -915 mV).
5 Rocod the voltago observBd betwe€n the protectod and the unprotected structures when conducting point_to_point tosta ng (e.9. 17 m\4
> This s ction mey be dilizod to conc,uct rn€surBments of continuity on uncrsfgpund ctq-ae€ tank syste.ns trEt arc protBcted by cathqlic p.otecton systerns> wtlon co.Eudjng a fixod coll - rnovino ground sr.lvey, h6 r€fErence et€(trod€ mLBt bo placed in th6 soil at a rErnole tocstion aho left undisturDed.> Corl(lud rint-fpcrint Esl b€tweon gny tvro guuctur€s br\r,hidl the fxod celFmo$ng gruJnd suryoy is incoodusiw or indi(aos pcaibka coflunuiry.> Fo( galvanic systsflls, tro structuro that is.to be p(otoctGd must be isolated from any ot|€r m€tallic srudurq in order to pa$ the continuity sun €y
FACIUTY i{AIIE:
STRUCTURE "A'' 'STRUSTURE'8",slnucrunE.e.'
FD(ED REi|OTE
VOLTAqE
sTnucnrRE .e,'
FXED EEIOTE
VOLTAGE
porxr.To+orxr'
YOLT GE
DlfTERENCE
!1i.-l?:l"i irilFi { i:t', (rxrnpar} ;,ii.L ili +.'. ... "-' -.
'.1|'.gr.tl. PREMIUM TANK FILL' RTSER ii!!ir!l l;ivf:{(elInd.) JA}ri
'i#ii.{:015 mv.{1i.?ilY,ii$l$t4+.iii,'r
.:i:1:i: {crnC.) ti: . ,
' :r lt{@}tcl-usnE :"
.:.rY.(rgq.) l-:i-
.i , ISO{.ATED':,,
,l /tlvr-r
(
xlll. GALVANIC (sAcRlFlGtAL ANODE) CATHODIC PROTECTION SYSTEM CONTINUITY SURVEY
6 Documsnt v/h6ther the test cell end/or to inclicaled the slructure was isola continuous or incondusive
I
I
Nov 07 oB o3: 17p trJ i mmen E I ectr i c go 1z6zg?s 1 p. 3Y7Etm
/\1 Woat>'l
COUNTY &// 1,. L<-
CP TESTERS CERTIFICANOil NUMBER +/
EXPIRATION DATE: 2
PHONE NUHBER:
f,,tt- 5/? - T?O
tr PASS
All prolected structures at this faqlity pass the calhodic proteclion survey and it ls iudged that adequate cathodic protectron has
been provided to the UST system (indicate all cnteria applicable by completion of Section Vlll)
One or more protecled struclures at lhis facility fail the cathodic protection survey and il is Judged thal adequate cathodic
proteclion has not been provided to the UST system (indicate tvtrat action is necessary by completion of Seclion lX).
DATE:
Nov072ffi
DEQ
Envlronmental Rssponso & Remediatlon
) Access to the soil direclly over the cathodically protected structure that is being evaluated must be provided.
) A site drawing depicting the UST cathodic protection system and all reference electrode placements must be completed
II. UST FACILITYI. UST OWNER
ro, t76O/37?L),^.,, r, flr,'/,;, r L;nl-/,*NAME:
I
I
I
NAME:l),)^d f it,+.i'? /,ni/t it I,
ADDRESS: Sss a tu*hADORESS:5:3c Sia P',/e, '1,, u
CP TESTER
STATE:tl t{
CP TESTE
CITY:
TESTER,S NA,TIE:*'1 l.Yte
o
:d+ uvCOTTPANY NAIIE
ADORESS
*erc: /1/",n, (on6rri/le
uthin 6 rnonths of installatiorrrepatr &J ther€fier)
D
Re-survey afler reparr/modificationE SO<ay re-survey afrer fail
REASON
! Routine - within 6 months of installalion
sun/ey must be conducled
D Routine-3year
oate nexl cathodtc
VI. CATHODIC PROTECTION TESTER 'S EVALUATION t'-*"nrr eoql
E
T
All protected struclures at this facility pass the calhodic protection survey and it is ludged that adequate c€thodic protection has
been provided to the UST system (indicate all criteria applicable by completion of Section Vlll).
One or more protecled structures at this facility fail the cathodic protection survey and il iS iuc,ged that adequate cathodic
protection has not been provided to the UST system (complete Section lX)
lf the remote and the local do not both indicate the same test result on all protected slruclures (both pass or both lail)
PASS
FAIL
ll rxconcuusrve be evaluated and/or conducted by a corrosion expert (complete Seclion Vll)nconclusive is indicalqd and thgSurvey
CP TESTER'S SIGNA
rov[.
/o-,-9
T'S EVALUATION
OATE CP SURVEY PERFORIEO
by a corrosron expert whenr a) an tn@nclusrve is indicated br any proteded struclure $nce both the local and the
the same outcorn€ (both pass or both hil), b) repairs to galvanrzed or un@ated steel prpng are conducied o. c)rernoE strudure-Gsorl potentials c,o not result in
The survey must be evaluated
an codewrthout folanodes are added to the lanks ancl/or
COTIPANY ilAUECORROSION EXPERT'S NAME:
NACE INTERNATIONAL CERNFrcAION NUMBER:XACE IXTERNANONAL CERTIFICATION
CORROSI T{ EXPERTS SIGXATURE
Vlll. CRITERIA APPLICABLE TO EVALUATION (mertrturaeppty)
Strudur+tosotl potential more negative than -850 mV v/ith respod to a Cu/CuSOr reference ele6roc,e wth lhe p.oteclve
qJrr€nt appli€d (This cntonon rs applicablo to any galvanrcally protoded strudure)
Strucluretosoil potentlal mor6 negattve than -850 mV wth respect to a Cu/CuSOr refBrerc€ elecuode wlth proteqrve current
temporarily Interrupted (Thts cntenm rs applicable only to ttros€ galvanic systems where the anodes can be disconnecle'd)
Structure tested exhtbtts at least 100 mV ot cathodrc polanzatron (Thrs cfltenon rs apdcable lo galvantc systerns where the
enooes can be t€mporanly dlsconnected)100 mV POi-ARIZATION
B
T
850 0N
850 oFF
IX. ACTION REQUIRED AS A RESULT OF THIS EVALUAT]ON (,n rtooryon )
NONE Cathodic prolection is adequate. No further action is necessary al this time. Tesl again by no later than (see Section V)
RETEST Cathodic proteclion may not be adequate Retest during the next 90 days to determine if passing resulls can be achieveo
! neeln S RETEST Cathodic protection is not adequate Repair/modificatron is necessary as soon as praclicat bul wrthin tl}e nexl 90 days
Wtr
tl FAIL
GALVANTC (SACRIF|CTAL ANODE) CATHODTC PROTECTilSYSTEM EVALUATTON
titrrh Dl'lQ tlntlcrgroilnd "Sft,nigc Tlnk Pnrgrarnr ,
crrt: f)tf,117.-
n4lla'+
,h.* ^ntu M-l
_\
!
TANX 'PRODUCT CAPACITY TANKS PIPING FLEX CONNECTORS
1 lo,. /;u 7,dco {}; -B lr*onl ru4 /A/h
2
3
4
5
6
7
I
9
10
XI. DESCRIPTION CATHOOIC PROTECTION SYSTEM REPAIRS D'OR TION. :
Corndee i( any repairs or modrfrcatioN to the cathodrc protedim system are made or are nocassary. Certain repairs/rnodificatrms are roquared to be de$gned
andor evaluated by a cofioslon e4ort (cornpl€tion of Secton Vll requtred).
Supplern€ntal anodes for a sti-P1o tank (anach @nosion expert's design or documention industry standard wss lollo\^Ed).tr
X Supplernental anodes for metallic pip€ (attach conoEion expert's design or doarmention inclustry standad wa3 follou,ed)
u Galvanicslly prolected tankvpiping not electrically isolated (explain in "Remarks/OttEf below).
futryLRernark9Other:
/"o
Attadl d€t8il€d drewing or us€ th6 space provided to draw a sk€Eh of fr€ UST 8nd csthoc,ic protoction systofils. Suffcient d€tBil must be grren in ord€r !3 dearly
indacat€ whorg tho rot€rsnco electrode was placed lor oach structuGtcsorl potental that is r€corc,ed on tho survsy brma. Any p€rtinent clatia musl also be
indud€d. At a rmnmum you should indicato th€ blloi,{ng: All tanks, prprng and disponsors; Al UJildings and strgsts; All anodes and wres; Locatbn ol CP test
s(aims; Each relar€nca decfo(b placernont must bo indicat€d by a code (1 ,2, T-1,) corresponding wth the appropristo line number in Secton XIV of this brm
AN EVALUAT]ON OF THE CATHODIC PROTECTION SYSTEM IS NOT COMPLETE AN ACCEPTABLE SITE DR.AWNG
Sh'y
N
i, /l
I7*y
.\
I
This sdbn rnay bo ut,liz€d to condJct m€asurHnents ol continutty on underprcund stofagp tar* systems hat afr protected by cathoclic protection systems.
\ rh€n oortducting a fixod call - moving ground sun8y, he rebrenco eleclrod€ must be plsced in th€ soil al a rBrnote location and left undisturbed
Corlduct b€nile€nEst t$,o forstudurBs indicatesor cDnbnuitypcsrUepornt-bpdnt 8ny
tlretoForhethatstruduretotsb€protected
't,/),.,^.,,- F,/r.*.,'.FACILITY TIAXE:NOTE The umy is nol mplele unl638 all applieblo pans ol Soctions l-xlv aro als
O€SCBBE LocAITON Of 'FIXED REIOTE' REFERENCE ELECTROOE PLACEI'ENT:
STRUCTURE'4"
FUED REIrcTE
VOLTAGE
staucruRE'B''
FIXEO RETrcTE
VOLTAGE
potxt.to-porxt'
VOLTAGE
OIFFEREI{CE
rsoLlrEcr'
CONTINUOU9
rxcoltcLUsNESTRUCTURE "A" I STRUCTURE "8":
(.ffrd.), (ssnC.) iir..i N@naq.usrvE"
:.ii (.xrnplc),' .. (.xsrndc) /,,','..'i.921 mV ,f.i'-*-iiiitrr,."cir' .'.; i;'. (q'I9la) . : : n :\ i'.', -j. {. i : : :
TYtoWPREM|UM TA},IK BOffOM iiit'q:
':." ; -:+.'+-.-',,i'.:'t--;'.r !.i" . I ' .1 ,- "il
:,,',i..'l i .
1,ii:,;.lr(aramda) r- )
.r,,i1.17 mV '' i
,, .,r' (.End.) I j:. ISOLATED ,'
(t
COI{TENTS:
1 Oescrib€ the cathodically protectd structure that you are attempting to demonstrate is isolated from unprotected structures (e.9. prem. tank).
2 Describ€ the unprotected struclure that you are attempting to demonstrate is isolated from the protecied structure (e.9. premium tank fill nser)
3 Record the measured structure'to.soil potential of the cathodically protected structure fA') in millivolts (e.9. -921 mV).
4 Record the measured structure-to-soil potential of the unprotecled struclure f BJ in millivolts (e.g. -915 m9.
5 Record the voltage obsorved between the protected and the unprotected structures when conducting point-toroint testing (e.g 1 7 mV).
6 Document whether the test (fixed cell and/or Point to point) indicated the protected structur€ was isolated, continuous or inconclusive
xil. GALVANTC (SACRTF|CTAL ANODE) CATHODTC PROTECTION SYSTEM CONTINUTTY SURVEY
..i . :...,-:,,,,'''
I
This s€ction may b€ uttlized lo conducl a survey of a galvanic cathodic protectron system by obtaining structurBtosoil potential measurernenls.
The relerence electrode must be placed in the soil diredty over the tested strudure (local) !O!l 2$100 leet away lrom the strudure (remote).
Both fle bcal and the remote voltage must be 450 mV or more negative, in order for the struclure to pass.
ordo
lz,NOTE: The sMy a3 not snplelo unl€t! all spplic$l'o Partr ot loctlos I - XIV ile olrc @rpl€l6oFACIL'TY XA[E:vUr
O€SCruA€ LOCANOX Of REIrcTE REFERENCE ELECTROOE PLACETTENT
REMOTE
VOLIAGE.
PA9A' XU
TNCOaaCLUSTVEVOLTAGE.
LOCALLOCAL REFERENCE CELL PLACE'TENT.CONTACT POINT tloc^noxt
cooE STRUCTURE:
.. (sxsmC€)
,..ITANK BOTTOM
(examCe) ,'{90''(6xatnd€)
€85
-/to 1 lts s-/x/ f,&orr4., //z-"11E"h,la,I
P. n.-/iao -///o//r,/t, D,.',tzrtgz/r.- blulP,_,7I
I
I
L
COXTEXTS
1
2
3
4
5
6
7
O€scnb€ where @ntact wrth the strucfiJre trat is being Ested is made (e.g. dus tank @ lest lead; dae€el PtplrE @ dispenser 5/6; lank test lead, ppa, etc)
oe6crib€ the exact locat on where reference oleclrode is placed lor eacfr 'local' measurement (€.g. sc'il @ plus tank STP; soil @ dispons€r 5/6, etc )
Record 01€ struclurB.tcsot potential rneasuEd wrth the reference electrocle placed'local'in milli\olts (e.9. -865 mV, -920 mV, etc')
R@rd i,|€ struc!,jrE-to-sotl potential rn€asur€d ffth the rebrence electrodo placed'remote' (copy voltag€ that was obtained dunrE @nlnulty su^€y)
of the test dataor lail€d Ul€ -€50 mV 'on' crlterlon bas€d oolndicate wh€tlor fie stsrJ(tur€
r-2,1P.P-2 etc.1 ,2,3.electrode'local'eacfi (esglacenientreterenceoncodesitethedra,vtngorbynurnencallyO€srgnate
connector:flexsubrnersiblediesel etc.)tested tank;pumpisttratpluspipang;preriumth€Oesctibe stn cture being (e.9.
xlv. cALvANtc (sAcRrFtctAL ANoDE) CATHODTC PROTECTTON SYSTEM SURVEY
I
Spackman Enterprises
705 North 1000 West #9
Centerville, UT 84014
SALT I.AKE CITY***Lrr
,!oI
7445 MAILEo F8ol,l zP coo€ 8+0f
IDERR
168 N. 1950 W.
P.O. Box 144840
salt Lake city. uT 84114-4840
tt,,li,,tt,,fir,,ll,t.,l,l, Jt,,l,,l,,lll,,,,l,,llt,,,,,l.ll
)
Erii t++4&4,i
"n
JON M. H SMAN, JR.
Governor
GARY HERBERT
Lieutenant Governor
HECEIVED
AUCI | e 2m5
DEO
Erlyrr0flrnofllBt RCt0onlt I flmldietionState of Utah
Department of
Environmental Quality
Dianne R. Nielson, Ph.D.
Executive Director
DIVISION OF ENVIRONMENTAL
RESPONSE AND REMEDIATION
Brad T Johnson
Director
August 3,2005
To:Gary Wimmer
Wimmer Electric & Lighting Co.
5330 S Riley Ln
Murray, LIT 84107
Re: Non-compliance of underground storage tanks at Wimmer Electric & Lighting Co., 5330
South Riley Lane, Murray, Utah
Facility Identification No. 400127 9
The Utah Underground Storage Tank Act (ACT) provides that the Executive Secretary (UST)
may revoke a Certificate of Compliance, if it is determined, that a facility is not in substantial
compliance with all state and federal UST statutes, rules, and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and
Remediation (DERR) performed a compliance review for the underground storage tanks (USTs) at
the above facility. The compliance review, performed on June 16, 2005, indicates you have not
satisfied the requirements of the Act and are out of compliance. To achieve compliance, you must do
the following:
Submit documentation to show that you have had a qualified cathodic protection
tester test your cathodic protection system within the last three years for UST #1
including thc product piping
Submit evidence that proper Inventory Control is performed on UST #1 by
submitting a copy of a current precision tank tightness conducted in the last 5
years.
The above information must be submitted to this office by September 16, 2OO5. If you fail to
submit the required documentation as requested, you will be charged $70.00 per hour for time
and travel as allowed by statute, for every follow up inspection necessary to document
compliance. If you have questions concerning this matter or need any assistance, please contact Paul
Harding at (801) 536-4108.
168 North 1950 West. PO Box 144840. Salt Lake City, UT 841 14-4840. phone (801) 536-4100'fax (801) 359-8853
T.D.D. (801 ) 536-4414' www.de q.utah. qov
I
2
Precision Testing Technorogies, Inc.
RECEIVED
AUG l9 20s
DEQ
fnvrronmenlll Resoonsi t Bmrdietio0
9t)t) ll t\t )6llt,\t, tlt
.\'ttlt Luk( ( it.t', I htlt li4l lt)
ts l-llllh-9224
tttl-$16-011t0 l'u.\
August 12,2005
Wimmer Electric
5330 S. Riley Ln.
Murray, Utah
Horner EZY 3 Negative Pressure Tank Test.
Horner EZY 3 Iocator Plus Method
The Following tank has been tested with the l{omer EZY 3 locator Plus Negative Pressure
Tank Testing System. This system meets all requirements set forth by USEPA 40 CFR and
bas received 3'd party certification'
All tests are perfomred in a professional manner and within courmoo practices of the
industry. However due to the variables of tank testing, these results cannot be guaranteed.
There are no warranties expressed witten or implied.
Testdat€- 08i11/05 FacilitYlD #-
Tester-Johnlabrum Certification#2l8l32 Utah Cert' #UT0l48
Taok ID- Unleaded Tank Capacity- 4k
Inches ofProduct- 24
Inches of water- 0
Inches of watet outside ofthe taok- 0
Maximum determined prcssure- 31.22 wcg Test Pressure- 32.7 wag
Minimum detemhed prcssure- 17.33 wcg
Acoustical Leak Detection- Pass No Ingress Detected
Threshold value- NA Pressure result- NA
Test Duration- I hr. 05 min,
Water intrusion-NA Water Ingress Test- NA
Test Result- l2k Diesel Tank- Pass Includes Suction Line
Ifyou have any qtrestions conceming this report, please call me at 801'886-9224
,
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I i'i -:0
JON M. HLI ,.JMAN, JR
Govemor
GARY HERBERT
Lieutenant Governor
State of Utah
Department of
Environmental Quality
Dianne R. Nielson, Ph.D.
Etecutive Director
DIVISION OF ENVIRONMENTAL
RESPONSE AND REMEDIATION
Brad T Johnson
Diredor
August 3,2005
To:Gary Wimmer
Wimmer Electric & Lighting Co.
5330 S Riley Ln
Murray, UT 84107
Re Non-compliance of underground storage tanks at Wimmer Electric & Lighting Co., 5330
South Riley Lane, Murray, Utah
Facility Identification No. 400127 9
The Utah Underground Storage Tank Act (ACT) provides that the Executive Secretary (UST)
may revoke a Ceftificate of Compliance, if it is determined, that a facility is not in substantial
compliance with all state and federal UST statutes, rules, and regulations'
At the request of the Executive Secretary (UST), the Division of Environmental Response and
Remediation (DERR) performed a compliance review for the underground storage tanks (USTs) at
the above facility. The compliance review, performed on June 16, 2005, indicates you have not
satisfied the requirements of the Act and are out of compliance. To achieve compliance, you must do
the following:
Submit documentation to show that you have had a qualified cathodic protection
rester test your cathodic protection system within the last three years for UST #l
including the product piping
Submit evidence that proper Inventory Control is performed on UST #l by
submitting a copy of a cun'ent precision tank tightness conducted in the last 5
years.
The above information must be submitted to this office by September 16, 2005. If you fail to
subntit the required documentation as requesled, you will be charged $70.00 per hour for time
and travel as allowed by statute, for cvery follow up inspection necessary to document
compliance. II-you have questions concerning this matter or need any assistance, please contact Paul
Harding at (801) 536-4108.
l6ttNorrh l950West.l,Ollox l4484O.SaltL..;rke ('ity. ll'l't't.lll4-4ti40.phone(801)536-4100'fax(801)359-8853
1'.l).l). (ll0I ),536-44l.l . rt'rt'tt.dtq.utuh.grt|
I
2
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Owner Name WIMMER ELECTRIC & LIGHTING CO WIMMER ELECTRIC & LIGHTING CO.Location
Address 5330 S RILEY LN Address 5330 S RILEY LN ( 200 W )
City MURRAY state UT zip 84107 City MURRAY State UT Zio 84107
GARY WIMMER Phone 262-8780 Contact GARY WIMMER Phone
Tank lnstallation Date 9/1 1/1 998
Capacity ot Tank (in gallons)4000
lndicate if tank is siphoned or compartmented. Show related tanks.
Substance Stored 6aidtthe
Tank is in use,Currently ln Use
Yes No Yes No Yes No
lf not in date last used and in tank.
Current year tank tags are in place.
of
Material of construction of tanks Galvanic Cathodic Pro
Material ol construction of piping Bare Steel
Pipinq tvpe Safe Suction
Type of Spill Prevention device. Note on form if tank is tilled by translers
of less than 25 qallons. lf so, no spill Drevention is required.5-+t'J,.
Spill containment bucket is clean, drv, and free of product, water, debris.(fc No Yes No Yes No Yes No
A".A (^,,fType of Overfill Prevention device. Note on form if tank is filled by
transfers of less than 25 gallons. lf so, no overfill prevention is required.
lf an overfill alarm is the primary overlill device: Alarm is located where it
Corrosion Protection method used on tanks
and and alarm is marked.
STr P3
No Yes No Yes No Yes No
t)LCorrosion Protection method used on pipino
d.* qL At disoensers:U", lL-, 5SCorrosion Protection method used on llex connectors, swing ioints, etc.
At tanks:Yes rNo)At dispensers:Yes <AJo->Enclosed containment sumps are present at tanks and dispensers
Yes
Containment sumps are sealed, free from watqr,.prodyqt, etc.
Cathodic Pfo .ctlqn Tedtiitg. Shoriiirfiexesult$'olthe most recent test:
The results ol the last two cathodic protection tests are available (within six
months of installation and every three years thereafter).
volts voltsw A\to*ErriL'.cTank Tester volts volts
volts volts volts voltsPiping Tester UT Date
volls volts volts voltsFlex Connectors/ Swing Joints
Tester
At tank
At dispenserUT Date volts volts volls volts
For lmpressed Current Systems: The results ol the last three equipment
operation checks are available (required every 60 days).Yes No
I 0
Name of
Disiribution:
tr Emergency generator tanks only; leak detection defened.
tr USTs temporarily closed and empty; leak detection not required.
tr USTs temporarily closed, locked and secured.
COMMENTS
Ldcheck0804.d@
Facilitv lD 4oo127sUtah I-IST Program
Retease Detecr ,r lnspection Checklist Paqe 1,,', of ' 2
OwnershiO of Tanks
Complete for each tank. !l the facilltv has more than four tanks. comple 6..triiE{ii
Number of tanks at the facilitu:
"""/
ilr- '
Yes i'1"
0r. eech 0r flex,c,onnGctol
l,J ez;L " i
on
Utah [$t Program ,-r
lmientory Control "- .R Manual Tank Gauging
Facility tD 4001279
Pase 2 ot 2
TANICLEAK DETECTIoN TTT/1.C.
Method used for tanks: t':f I Tank tiqhtness Testing/lnventory Control [ ] Statistical lnventory Reconciliation [ ] Manual Tank Gaugi4g
SIR/ T-rT/ LTT 3rd party c rti!qq!i9! qyql!q!!e:Yes NoSIR system used:
Circle Yes or No for each ouestion. ln the last column, explain and identify by tank any exceptions to the answers given in the first column.
No((epGsrn
lnventory readings for product inputs, withdrawals, and the amount
remaininq in the tank are recorded and available for each operating day
Records show proper sticking and measuring of product level at beginning
and end of inactive period of aooropriate lenqth.Nov"/lnactive period 36 44 58 hrsMTG
. YeBr NoIC SIR
Product inputs are reconciled with delivery receipts by measurement of the
tank inventory volume before and after deliveries.
No(JF>
IC SIR MTG
lnventory readings are properly reconciled monthly (weekly and monthly
for MTG) to the appropriate allowable amount.
Qr"5 ruo
Type used: j; I ,'.,' kIC SIR MTG
Equipment used to take readings (ATG, Gauge gJclt, etc.) is adequate,
accessible, and operational. IfATG is used, system has proper
documentation of setup, calibration, etc., and oryler'! rnq!qqlE-pl9q9!!
@-) ruoIC SIR MTG
An appropriate calibration chart is used to convert product level readings
to qallons, and is available for review.(D *oIC SIR MTG
Documentation of valid testing or monitoring is available for the last 12
months. Show results in table below.
@ NoIC SIR
Records include the appropriate number of water readings, and water
readinqs are used to adiust inventory balances as necessary.
Yes ) No Calibration date:
'ln.O ehtt*E*
IC SIR
Dispensers have cunent calibration stickers or proper calibration
documentation.
-tr-D NoIC SIR
Drop tubes are present and extend to within one foot of the tank bottom. (
Show results of monitoring for each tank for the last 12 months. lf the final monthly over/short value exceeds the allowable for lnventory Control,
indicate whether the value is over (increase in volume) or short (decrease in volume).
1/05 2t05 3/0s 4t05 5/05 6/0571048/04 9/04 10/04 11t04 12t04Mol/r
i
1te'p f,l"t-'P r#!r f)l:1)
g
#
#
Tank 1 Tank 2 Tank 3 Tank 4
Results of last tank tiohtness test are available: Y fu\ lJ z-.1,*r"\Results:
Test Date:Tester name and cert, number:UT Test Method:
OTHER
'and one other method are required for Pressurized Piping):
I Line Tightness Testing [ ] lnterstitial Monitoring Type of lM Documentation
atAaD
linEfualdetector
I Vapor Monitorinq
[ ]Automatic Line Leak Detector tt I Statistical lnventory Reconciliation I
PIPING LEAK DETECTION
Method(s) Used (Automatic
[ ] Groundwater Monitoring t I .2 GPH Monthly fesling
Safe Suction Piping: Documentation is available and verifiable to show that pi
valve (under pump), and has proper slope of piping.ffi""t"t at less than atrnospheric pressure, has only one check
No
Tank 3 TankSTank 1 /Tank2/Llne Tightness Testlng, Llne Leak Detector Testing:
/ResultsResults of last line tiqhtness test are available: Y N
Tester name and cert. number:Test Date
S*/.fe S MES YESType (M- Mechanical E- Electronic S- Sump Sensor):
(
Automatic Line Leak
Detectors
Manufacturer and model of each leak detector:
(
Results of last leak detector oerformance test are available: Y N Results
Tester name and cert. number:Test date:UT Test Method:
Show results of monitoring for piping for the last 12 months. lndicate Pass, Fail, lnvalid, or No Results for each month.
Moffr
#
#
(
COMMENTS
15:81 252-879:t-I,IIMMER ELECTRICA PAGE 21.
wlliltilEt El-ECErlc-
e, [lcrimc co,, lllc.
5330 Rl Vuarue , MURRAY,UT 841 oz o pnonE (801 t 2624780
DATE i
ql teloe*
TIttEt ', oo
TO!ic\or
FIRl.f/DEPTS
TOTAL NUMBER OF PAGEE INC LUDING COVER PAGE
FRODI:
FIRti:
sEP I 3 2002
ENVIR0NMENI* ti,ltHt8t
& REMEDIATiCI'i ,
DERR
\itD-tA I\
BY
50n
COcoH}lENTs r
IF you DID NOT RECEM ALr. PAGES r.H GOOD eONDMION' PLEASE ADVIBE ASAP.
oun FAx No. rs r-801-262-8791
83/t3/Z:8,42-
EI\CS rMr tE TSINSI'{I SSro.N
cov3[ PAGE
Zg/13/2Ab2 16: A1 262-8791--'
OATE OF THIS MONTH'S WATER LEVEL CHECKi
I'IMMER ELECTRIC PAGE S2
MONTHL ]NVENTORY BECORD
OT\
MONTT{/YEAF I
FACILITY NAME:
IANK CONTENIS:V1h
t^AMOUNT Or WATEF (INCHESI:
(
LEAI( CHECK:
TOrAL of 'DAILY Ov.* o^ tfo"]-
IF ANSWER IS'YES'TWO
TOTAL GAIONS PUMPEO
t a\7-- )x .01 +
ts TARGER THAN TH€ 'LEAX THECK FESULT
rorn cetloes oven on SHOET
130
Yes
'rolar GAlLol{6 ?uMPEo:
zdo,lI
NO
MONTHS IN A ROW, NOTIFY REGULATORY AGENCY
Er{o sTE(NrrEtlroFv rrt^LsDAI.Y OVEF
on <slxl8r,
GAr.LoLssrcXEs
D
STAET EIET !x\rEllloF '
G Llo}{s
-OELrvtecD
aag
TvEITOFIGAlLollS
PUla?tD
OATE
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I3 o
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5
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?!zb'ot-77
23 ,LL'oLc'.7I t)75
26
21
o2a -4)
2o
!o
3r
ffi[u
JilIID
sg
KEEP THIS PECE OF PAPER ON FILE FOR AT LEAST ONE YEAR
FEOEiI l- vEurl. 2'JrqJ '
asl13/2@A2 I6t@1, 252-879\
DATE OF THIS MONTH'S WATER LEVEL CHECKI
t4rMMER ELECTRI9^ PAGE 83
MoNrHt; inveturonv BEcoRD
MONTWYEAR :
FACILITY NAME:
TAN( CONTEMTS:
1l b, AMouNr oF wATEB (lNcHEsli
n tr (,
fiw
n
u
U
ioteL clttoxs PUMPED
YOTAL GALLONA PUMPED
LEAKCHECK: (1Lo
IOTAL GALLO}|S Ov€F OR SHOFT i
.ot + 130x
L -aoa" r** r*e't"ElK bxecx' nesulT'
TOTAL OF 'DAILY OVER OF SHORT
IF ANSWEB IS.IES" TWO MONfHS IN A ROW, NOIIFY REGULATORY AGENCY
c
Ello sTEr n{\fEXTOlf,irfItaLSorl.Y 6,Ea
OR <8tffiT>
c^tLol{3Hq}lfA
/-)
itrnr srrr rialrEtatfr I
c|rLLOrrS -O€LIYIiED
smr
HVEXTO '
oAlLo s
?UM?ED
OATE
o
'I b
2
lo3
6
6
c)\1
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t-2
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2!
L\22-L o1b12202A
D2a
25 O()
26 O1VZ7
Ib?r
b129il)\4o'2-Dt30L-)o?43l
KEEP THIS PI€CE OF PAPER ON FItr FOR AT I'EAST ONE YEAR
FESDI{a. vrFrEt I ' Jll{lll
09/ 13/ 2AO2 16:81 262-8791 ^HIMMER ELECTRIC,.\
MONTHLY rN
PAGE 04
VENTORY BECORD
MONTHNEAR :
FACILffY NAME
TAN( CONTENTS
(u
\n4
OATE OF THIS MONTH'S WATER LEVEL CHECK:
AMOUNT OT WATER (INCHESII
TOTAL CALLONS ov€F OR SHOFT.
TOTAI. GALI.ONS fT,,MPED:
roTAL GALLoNS PL,MPED x .ot + lg0
uA< cHicr: , 9,q, .
TorAL oF'DAILY ot"" ot =*"*L tAFGEn rHAN TllE'ulr buecr BesuLT; YEg
IF ANSWEF IS'YES'TWO MONTHS IN A BOW' NOTIFY REGULATOR
(EEP THIS ercE or papen oN FILE FoR AT LEAsr oNE YEAF
kcL_.EDt
Y AGENCY
SIEI'E NO !llftaLsDAIY(rrrEi
oF <6Ho*r>
GALLOII6${CHCSGALLoLg
-DErtYfiEDSTAfrTSTEX+fi\,Ei[oFl
G rlora6
PUrltEo
o TE
b5o'lPr 6 ?1 s
3 ,)
a
O \lL
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29
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tA YD-\4 ]flLIt
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I
711
I
n
1\\r\r4
-t141--
30
Michael O. Leavitt
Govemor
Dianne R. Nielson, Ph.D.
Executive Director
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box 144840
Salt Lake City. tltah 841 l4-4840
(801) 536-4100 Voice
(801 ) 359-8853 Fax
(801) 536-44r4T,D.D.
Kent P. Gray
Director
May 30,2002
TO Wimmer Electric & Lighting Company
Attn: Heather Sundquist
5330 South Riley Lane
Murray, Utah 84107
RE: Non-compliance of underground storage tanks at Wimmer Electric & Lighting,located at 5330 South Riley
Lane, Murray, Utah; Facility l.D. # 4001279.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all stare and federal
UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on April 09,2002, indicates you have not satisfied the requirements of the Act and are our of compliance.
To achieve compliance you must do the following:
l. Submit evidence that proper Inventory Control is performed for the months of June 2002-August2002
on your 4000 gallon UST by:
a. Documenting that the liquid volume in your UST is measured, each operating day, to within one-
eighth inch, including measurement before and after each delivery, and reconciled to daily
withdrawals.
b. Documenting that inventory records are reconciled monthly to determine the total overage or
shortage for each UST, and the variance is compared to the altowable of 130 gallons plus one
percent of the UST's monthly throughput.
c. Documenting that the water in each UST is measured to within one-eighth inch, at least once per
month, and the water measurements (converted to gallons) are used to correct the monthly
inventory reconciliations.
Please return a copy of this speed memo with the above items to speed processing. If the above information is
submitted to this office by September 0612002, and substantial compliance is achieved and maintained, no further
action will be taken on this matter. Failure to respond to this request by the date specified will initiate the revocation
process for your Certificate of Compliance. If you have questions concerning this matter or need any assistance,
please contact Victor Scherer at (801) 536-4240.
1
-
Utah UST Program
Detection lnspectionRelease
!Ownership of Tanks Location of Tanks
Owner Name l^)tmrrn ep l?l ocl.-e,tt F L.i,.l ,^ "'Location Name lrJ r- nA E;1 EJecrg,c- P l,r. l,.pn. Co
city NA r.to-f4ha Qtate l-.Lf zip q.qlD'l
Jc)Address LoBBAddress
State t
g. lz, I TJ tar
contact
-$cotl,,ri S*0$*$lnon" Lt ). Qlqo -k-lLocationPhone
ka I3nf-3-Tanlrtl
Complete for each tank. ll facility has more
Number of tanks at facility:--Tade2
on
Tank lnstallation Date q\qg
Capacity of tank (in gallons)Ubo e,
Substance stored P.Aqolrno
Tank is in use (Y) or, if not in use, give date last used V
lf not in use, depth of product in tank (in inches)NA
Answer the all
Current year tank tags are in place TooL
Material of construction of tanks ( rE-E- t
Material of construction of piping <1EL l-
Pp #(€ au<For{ - No UrvE 7.esT-.-.--P&*r-crf2_eN
tf no IS red
rs
Piping type
less than
than 25
ype
'tqa,ttdrJ
Ato
and alarm is
an
marked Yes No
Method used on tanks
Corrosion Protection.
and
Method used on piping oP
Method used on flex connectors IUA
Enclosed containment sumps at tanks (subpump) and dispensers Yes No
lndicate dates o, upgrades- lining, tank or piping cathodic protection
for each tank, line, orCathodic
The results of the last two cathodic protection tests are available (wiihin
6 months of installation and every 3 vears thereafter).Yes No h
'lJt:X""n"lranx rester Jbrrv LalxwrPao*-Tdrgr. G-o tro F*6s {ue{,L*, .rrt YEr I -t oo?),""
f,o,nn r"S 1o;A"eryrSer'Nrrt{h crbr,&$;,rt[volts
9
volls \volls volls
Sub pump
current system three equipment
ired
r-T'
res
are 60
ments Wo T
r\OT C
\"t-t_L;
Yes No
"r\filt Pase I ot O
UN
Iary <Ak*A
r.tE <:-
volts
volts
volls
volts
volts
volts
f.c
\nsrr.Bng- Fo e
t(name) V rllo p 6cAef O1 certify that I inspected the above-named facility on (date)If
9-oDate
of Owner or Owner's C
Distribution:rev0302
txl!D
separate form.
c-P
volts
volts
Mbthod used for tanks: 2.M/.\r^AL-HANTO used lor
Manufacturer,name and model number of system:System 3'o party cert. available Yes No
lnDRecords on site document that the system is properly installed, calibrated, and
maintained (system and lank setup reports, maintenance records).Yes No
ATG IM Device documentation is available on-site (owner's manual, etc.)Yes No
Ail Equipment used to acquire data, take readings, perform test is adequate, accessible and
functional. lncl. ATG console, dipstick, etc.Yes No
Ail Documentation of valid testing or monitoring is available lor the last 12 months. Show
testino or monitorino results in orid below-Yes No
ATG The probe is located at the center of the tank. lf not, the tilt conection factor for each
tank is shown on the tank setup reDort.
Yes No
ATG The tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test and the tank size is within the allowed
upper and lower size limits.
Yes No
IM Secondary barrier is properly placed and constructed, designed for gw considerations,
has an acceptable permeation rate, is compatible with the substance stored, is non-
conodible, and is not in the 25-yr floodplain (per site assessment).
Yes No
tc Mlc
HR-
lnventory readings for product inputs and withdrawals are properly obtained anO X I
recorded. Readinos are oroperlv reconciled. ' \3N@
lcsln Records include the proper number of water readings, and water readings are used to (
adiust inventory balances as necessary.G No
D:trro
SIR
An appropriate tank calibration chart is used and is available for review.-JgrNo
.+d srn Dispensers have current calibration stickers or proper calibration documentation.rYes)ruo
tc $rR Drop tubes are present and extend to within one foot of the tank bottom.rf#., tto
Show results of monitoring for each tank for the last 12 months. lndicate pass, fail, no results, or inconclusive.
Mol/r
^,0 ru4gP-tzt 9,u#f,c-f {cs A^--,/\U-f l2J)/v\{\.L (-fr :!
#,\107 Pf itmctl Ito Trrc-+t ,"rtoD W,-L .o. {,{ ec-p'r.,r<
't le
,@ywh#I ,,
\J
#I
Tank 1 Tank 2 Tank 3 Tank 4
Di-rpar'=-* rr5h,l'c4-.lz:6r'xa Fg31hr"tr*Date of last tiqhtness test tor tanks:
Duta^ WaiName and certilication number of tester:Test Method:
Nh - sele su.rrarr\Date of last tiqhtness test for pipinq:Test results:
Name and certilication number of tester:Test MethQd:
Date ol last leak detector performance test:tt/4 - Sn6(,?;;#5
Safe Suction piping: Documentation is available and verifiable to show that piping operates at less than atmospheric pressure,
has onlv one check valve (under pump), has proper slope of pipino.
Yes No
Comments
Pro"A orN
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Ldall rev0201 .wpd
Utah UST Program
Tank and Piping Leak Detection
Tank and Line Tightness Testing, Line Leak Detector Testing:
Ownership of Tanks Location of Tanks
Orarner 1611p WIMMER ELECTRIC & LIGHTING CO Locarion 1q6 WIMMER ELECTRIC & LIGHTING CO
Adctess 5330 S RILEY LN Address 5330 S RILEY LN ( 200 W )
City MURRAY Sate UT Zp 84107 Gty MURRAY State UT Zip 841A7
Contact GARY WIMMER Fhone (801) 262-8780 Location Contact GARY WIMMEB Fhone
Complete for each tank. lf faeility hre more thar 4 tanks, ompl
Nunber d tanls at f rcility:d).3_)
Tark lnstallation Date 9/1 1i1998
Capacity of tank (in gallons)4000
Subtance stored Gasoline
Tark is in use (Y) or, if nct in use, give date last tsed Currstly ln Use
lf nct in use, depth of prodrct in hnk (in inches)l.J *
Cunent year tank tags are in place
Ivlaterial d corstruclion of tanks (sted, FBP, conposite, etc.)Protection (STlP3)
lvlaterial d corstruclion of piping (steel, FBR f lex plastic, etc.)Bare Stel
Hphg type (pressure, safe/US suction, gravity, eb.)Safe Suction
Type of Sill revenlion Ds/ice (<5 gd, >5 gal, cmt. sunp, etc.) Nlob
if f iled by transf ers d less than 25 gdlons. lf so, no spill reqlired.5rrr,-L!-dr/
Type of Overf ll Prevention Devbe (siutoff, ball lloat, darnl dc.) Mte
if f iled by transf ers d less than 25 gdlons. lf so, no overf ill required.
in the lat colum n.
can seen Yes No
hg for all tarks. lbte
lvlehod wed m tanls (trlvl CS, ll- C, SA, ND
narkedand alarmis
Corrosion Probction.
tvlehod rlsed trr pipirg (NI4 CS, C, SA, ND elsA
tvletrod rced m f lexconrBctors ((G-,\ruC, CP, NM NP, NA)C<
Enclosed conta'nnBnt sunps at tanks (subpnp) and dspersers (NloG
lndbate dates d upgrades- linirg, tark or pping cathodc prdectim.
The resdts of he last tw o cathodic protectim tests are avail$le
(w lhin 6 npntls of irstalldion and every 3 years thereaf ter).I\b
(ranr Tester me s€E BE/..t r1]-
Qiping tester tDde l\
rdts \olts !dts \oltsFlex Connectors
Tester
Nf\'-ac-Sub purp
DisperErhte \dts \olts \dts \olts
'(crrtL04,
Yes Nb
n7,t ^
eqdpnert operation chec*s are avaihble. (requied every 60 days.)
mpresse m:
.*L& fc-)'.-q-A"o-c&\-' O lL'J tt-A-) r I
O2 C {,1,aJ.urLCv\(.
CP "t (l. o'qo/{€c /**(-Puw/614a /.
-o $-
ent
^ Utah UST Program A L^ . r
Release Detection lnspection Checklist uiaciril D 4oo127s
Answer the lollow ing for all tanks. l$te ary exceptions in the lct colum n.
1A
{"9
lnsrnr:lor's sicnalrrre \ ). , r*, ^ 9"h,
q)vllt
J
4,000
T n g ID 400'l
Utah UST
l/ethod used for Suction
3'd
the
lt/laruf acturer, nane and nodel nunber of
OTHER
cert. available Yes M
r fir
lrlefrod tsed f or tanks: TTT Y
{ii Fbcords on site docunent thd the systemis proper! instdled, calibrated, and
naintained (systern and tank setup reports, nEintenance records).6*
AtrQ IM Dvice docurrBntation b avdlable on-site (owner's nanLal, etc.)Yes Nlo
6ll)Quipnent tsed to acqdre dda, tale redings, perf orm test is adequde, accessible
and f mctional. lrpl. ATG console, dipstick, etc.QB*
qYes)Nlo
\AlI-/Dcunentalion of valid testing or nonitoring is avail&le f or the hst '12 npnhs. Show
bsting or nmitorhg results in grid below.
ATG The pobe is locded at the center d the bnk lf not, tle tilt correction factor f or eah
tank is shown on the tark setrp report.
Yes No
ATG The tank w as f illed to at leastthe nhinumlevd reqLired by the nanufacturer's
equipnent gotocol to ensure a vald leaktest and thetanksize is w itlfn the allowed
tpper and loar er size lirits.
Yes llo
Secordary barrier is property placed ard corstructed, designed f or gw
consi&ratims, lns an acceptable perneation rate, is conpatiUe w ih the substance
stored is nm-conodiUe, and is nd in the 25-yr f loodplain (per site assessnent).
Yes Nlo
l[/l
C MI'G
SlR
hventory readings f or prodrct inprts ard w itffirawals are prcperly obtaircd ard
recor&d. Fbadirgs are properly reconciled.GeJ x"
@n Fbcords include he proper runber ol water rcadirjs, ard w der readings are usedto
adjust inverlory balances as necessary.
,'=-(-YS!)No
Pure
SIR
An appropriate tank calbratim chart is used and is auail$le f q reviaiv @)"
3)sn Dspersers have current calbratim stickers or proper cdibratbn daunBntation €rb
G-J"G^hn Dop trJres are present and extend to w lhin orB f od of the tank bottom
Shotrr results d monitoring for each tank for tlre last 12 months. lndicate pass, fail, no results, or incorrclusitn
1A01 1toz 2l02 3l02 4t02 5l02 6t02 7lo2 8102 9t0210/01 11/01
na(-a*TbL or-OR ol<(y1"-.JA#3 I,wc,.,4,1
#6to"/''dY q/,)e_ .
f
#
Tmk 1 lanK'2 Tank 3 Tank 4
G" O lat tiqliness test tor tanls 5Etr Test results
BE/cl-tJ--Mne and certlication nunter d tester:Test lvbthod
Date of l6t tigltness test f or piphg:NA - Sn Pe <{/-r'/\)Test results
Mne andcertlicatim nunber d tester:Test lvbthod
Aubrnatic Line Leak Detector tvre and rncdd M H - SAle er,t t-rZdr'\
Date of last leak detector perf ornance test:Test results
Nba0Safe Suction pping: Docunentdion is availdb and verif iabb to show tt'nt piping oprates at less thil atnospheric
pressurq has only me check valve (under punp), and has propa slope of piping.
aY-f , C-P fioI ,ru f,te "*,.{Connents er.,\
Aof
I
Cirde Ye column-
[loffr
Tank and Line Tightness Testing, Lire
nar LOL n*l,J!s[ tQ
owner Name lrJ r,r^ rntr.? - l:\, r*+-rr - d. I r r.+rlv? to Locationt't"r" V0 tr*,r.n^qf Ele-Clr,. t L,<ht,n (r2
RouressE-R.BO 5. Rr LeY ' l.Nl N O5 gR,,1a oW
V\ u,"*r*l-ana state ttl ,oQQlG lc'rCity \
Contact \lS ?-t'7s0Phone
lr
I Location Contact t:'
foffnation,foi additi
b -tPhone
(.f""@ \-r3!! s )tNumber of tanks at facility:\antz/)Tank 4
-*J=3 qh I q trq-zTank lnstallation Date N q*/
Capacity of tank (in gallons)fiwo i&e t}gda
Substance stored koodtno q,"6a,L ou4A^,V Ly\Tank is in use (Y) or, if not in use, give date last used ,)d \-
Y
lf not in use, depth of product in tank (in inches)
Current year tank tags are in place
I
Ste- LMaterial ol construction of tanks (steel, FRP, composite, etc.)
Material of construction of piping (steel, FRP, flex plastic, etc.)'it"-[qAU StrcrtcPiping type (pressure, safe/US suctioq, gravity, etc.)L. t)
Type of Spill Prevention Devic{<54af>9gal, cont. sump, etc.) Note if
filled bv transfers of less than 25 qallqns-{so, no spill required.
than 25 no overfillif filled of lf
(c8ptiorts ]n the lasl
Yes Noalarm is
I seen
marked
311Method used on tanks (NM, QS, lL, lC, SA, NP)
Method used on piping (NM, CS, lC, SA, NP)1+
Method used on flex NC, CP, NM, NP, N/A)DgPens.-r.
Yes @Enclosed containment sumps at tanks (subpump) and dispensers
lndicate dates of upgrades- lining, tank or piping cathodic protection.
The results of the last two cathodic protection tests are available (within
6 months of installation and every 3 years thereafter). t
No
0a od DASSC.e,f.r-s-n n t!Tank Tester
oa 16()fruGPiping TesterD.6{- L oIaA o/1^\^ Date (g
voltsSubt Sub
volls
Sub
volts Sub volts" \rrotLl<l
rester Df 0 *. ' NR lu-'),"lFlex voltsDisp.voltsDisp.voltsDisp.voltsDisp.
Yes NoFor impressed cur(gJlt system: The results of the last three equipment
operation chec[<q are availablelrequired qvpry 60 Hays.)
'[t tA -vKdA
a -->r a UY\U O
t
G-.
{,vr-1_.h
c o *.;
yn
the above-named
of\Page
on
TC
that I
^or's
of Owner or Owner's i
Distribution: White-DERR, Yellow-lnspector, Pink-Faci rev0201 .wpd
Utah UST Program
Release Detection Inspection Checklist rD ,it o0 ltrl
Ownership of Tanks Location of:Tanks
\)
)
01,* t;1,t'
ol
Cathodic Protectlon Testing Complete for each tank.
Lre)
ltname) \l , -.-,p AJ^{,ar----
x
Utah UST
Tank ping
h=ffif fGetnoo used for SnMethod used lor tanks: I - e 3AA ITfiE
Manutacturer, name and model number of system:Svstem 3'o parU cert. available Yes No
Records on site document that the system is properly installed, calibrated, and
andeachCircle Yes
Ail
and tank maintenancemaintained @*o
ATG IM Device documentation is available on-site (owner's manual, etc.)Yes No
6*oAilEquipment used to acquire data, take readings, perform test is adequate, accessible and
functional. lncl. ATG console, dipstick, etc.
AI Documentation of valid testing or monitoring is available for the last 12 months. Show
testino or monitorino results in orid below.
-@ r.ro
ATG The probe is located at the center of the tank. lf not, the tilt conection factor for each
tank is shown on the tank setup report.
Yes No
Yes No
ATG The tank was filled to at least the minimum level required by the manufacturer's
equipment protocol to ensure a valid leak test and the tank size is within the allowed
upper and lower size limits.
Yes No
IM Secondary barrier is properly placed and constructed, designed for gw considerations,
has an acceptable permeation rate, is compatible with the substance stored, is non-
conodible, and is not in the 25-yr floodplain (per site assessment).
IC MTG
SIR
lnventory readings for product inputs and withdrawals are properly obtained and
recorded. Readinqs are properly reconciled.No,G
IC SIR Records include the proper number of water readings, and water readings are used to
adiust inventory balances as necessary.Yes No
Yes NoIC MTG
SIB
An appropriate tank calibration chart is used and is available for review
Dispensers have current calibration stickers or proper calibration documentation.Yes NoIC SIR
Yes Notc stR Drop tubes are present and extend to within one toot of the tank bottom
Show results of monitorinq for each tank for the last 12 months, lndicate pass, fail, no results, or inconclusive,
Mo/Vr
JLTAJY\.Lolj +-i.q.)-{.- C r tor liq 0r \* vlt r).4#MAru ^aL +o
I#
#
#
Tank 2 Tank 3 Tank 4
r)alqlq c Test results:Date ol last tiqhtness test for tanks:
Name and certiricarion numbei or teste, "8Xffi]'ffi Ut orjrffi*
Aqlqb Test results:Date of last tiqhtness test for piping:
Name and certirication number or tesrer: ?oFrof <- J^, f-nC Utgll,"\,"r'
Date of last leak detector performance test:plA Test results:
Yes NoSafe Suction piping: Documentation is available and verifiable to show that piping operates at less than atmospheric pressure,
has only one check valve (under pump), has proper slope of piping.
Comments
pao" ) ot?f
Distribution Pink-Facility/Owner revo201
lD rl00 rA
rf
Tank ITank and Line Tightness Testing, Line Leak Detector Testing;
P
' Facility lD:
Owner Name:
Owne. Address
Tank Status:
Date lnstalled:
Date Closed:
Tank Capacity:
Tank Material:
Tank Material:
Pipe ilaterial:
Pipe N4aterial:
Pipe Flex Connector'si
Pipe Type:
Substance Stored:
Overfill lnstalled:
Spill lnstalled:
Pipe Release Detection
Tank Status:
Date lnstalled:
Date Clossd:
Tank Capacity:
Tank Material:
Tank Material:
Pipe Material:
Pipe Material:
Pipe Flex Connector's:
Pipe Type:
Substance Stored:
Overfill lnstalled:
Spill lnstalled:
Cathodic Protection Met
ln Compliance:
On PST Fund:
4001275
WIMMER ELECTRIC & LIGHTING CO
5330 S RILEY LN
MURRAY UT 84107
Facility Name: WIMMER ELECTRIC & LIGHTING CO.
Street Addressr 5330S RILEYLN (200W )
MURRAY UT 84,107
UTM Coordlnates
424,215.58 4,500,598.28 Hand Held GPS with Base Station Corr
1
Yes
None
None
Steel
Tank
Fede
Tank
Date
Dat€
Tank
Tank
Tank
Pipe
Pipe
Pipe
3\
ral lated Tank:
9989l
rmanently Out of Use
It Coated or Bare Steel
lnstal
Closed:
Capacity:
Materiall
Material:
Materiall
iraterial:
Flex Connector's
Pipe Type:
Substance Stored:
Overfill lnstalled:
Spill lnstalled:
Cathodic Protection lvlet:
ln Compliance:
On PST Fund:
Other Financial Mechanism
Tank Release Detection:
Currently ln Use
9/11/1998
4000
Galvanic Cathodic Prolection (STl
None
Bare Steel
Cathodically Protected
Cathodic Protection Met:
ln Compliance:
On PST Fund:
Other Financial Mechanism
Tank Release Detection:
Safe Sucti
Gasoline
No
No
No
Yes
Yes
No
MTG TTT
Gasol
No
No
No
Yes
Yes
No
Sale Suction
Gasoline
Yes
Yes
es
Y
No
TTT I.C
Steel
uction
l,vr
Other
q1t
tc
OX-0""n.,t'-'
P,\Srlvu
Other Financial l\,lechanism
Tank Release Detection:
Friday, April 06, 2001
I TG TTT
Page 1 of I
Tank lD:
Federally Regulated lank:
Tank lD:
Federally Regulated Tank:
Pipe Release Detection:
Pipe Release Delection:
977
3
Yes
Permanen y Out of Us€
922t1977
9/1/1998
2000
Asphalt Coated or Bare Steel
None
Sale
1l., d
Companies that do Statistical lnventory Reconciliation
This list identilies companies that do Statistical lnventory Reconciliation (SlR). lnclusion on this
list is not an endorsement by the State of Utah. This list is subject to change without notice. For
up-to-date intormation regarding a company, contact the DERR UST Section at 801 .536.4100.
SIB Technol oov SIR Monitor
Route 1, Box 1532
Burley, lD 83318
Tel: 208.678.1784
Warren Floqers Associates. lnc.
747 Aquidneck Ave.
Middletown, R.l. 02842
fel 401.846.4747
Watson Sv stems. lnc.
4501 Madison
Kansas City, MO 641 11
Tel: 800.878.9747
Advanced Telemetrics
520 Cave
San Antonio, TX 78209
Tel: 800.382.1482
Computerizinq, lnc.
P.O. Box 99
Scottsboro, AL 35768
Tel: 205.259.1805
EntroDv L imited
S. Great Rd.
Lincoln, MA 01773
Tel: 617.259.8901
Horner Products. lnc,
104 Little Killarney Beach
Bay City, Ml 48706
Tel: 800.443.071 1
P.O. Box 2791
Murleesboro, TN 37133
Tel: 615.895.2872
R Phoenix lnc.
9 Ford Rd., P.O. Box 229
Leoma, TN 38468
Tel: 615.852.4121
The Simmons Corp,
106 E. Main Street
Richardson, TX 75081 -3327
800.848.8378
SIB lnlernational. lnc.
10235 W. Little York Rd., Suite 257
Houston, TX77O4O
Tel: 713.937.6886
TeleData. lnc.
43 East Ocean Blvd.
Stuart, FL 34994
Tel: 561.219.4661
USTMAN lndustries. lnc.
12265 W. Bayaud Ave., Suite 110
Lakewood, CO 80228
Tel: 800.253.8054
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box lzl4840
Salt Lake city, utah 84114-4840
(801) 536-4100 Voice
(801) 359-8853 Fax
(801) 536-4414 T.D.D.
Michael O. Leavitt
Govemor
Dianne R. Nielson. Ph.D.
Executive Director
Kent P. Grav
Director
May 30,200I
TO:Wimmer Electric & Lighting Company
Attn: Allison Wilson
5330 S. Riley Lane
Murray, Utah 84107
RE: Non-compliance of underground storage tanks at Wimmer Electric & Lighting Company, located at 5330
S. Riley Lane, Murray, Utah; Facility I.D. # 4001279.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary (UST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and federal
UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on April 11,2001, indicates you have not satisfied the requirements of the Act and are out of compliance.
To achieve compliance you must do the following:
1. Submit documentation that proper Automatic Tank Gauging (ATG),Inventory Control, or Statistical
Inventory Reconciliation (SIR) is performed on UST #3. The inspection at your facility revealed that your
current form of leak detection is Manual Tank Gauging (MTG). The UST at your facility is registered on
the state database as a 41000 gallon capacity tank. This information was submitted to the state by the
owner of the facility at the time of tank installation. Federal and state laws allow Manual Tank Gauging
as an acceptable form of leak detection on tanks 2,fi)0 gallons or smaller.
Information has been enclosed on the approved forms of leak detection that can be used on your UST. Please review
the material as each option has different regulatory requirements if implemented. Please return a copy of this speed
memo with the above item to speed processing. If the above information is submitted to this office by July 30,2001,
and substantial compliance is achieved and maintained, no further action will be taken on this matter. Failure to
respond to this request by the date specified will initiate the revocation process for your Certificate of Compliance.
If you have questions concerning this matter or need any assistance, please contact Victor Scherer at (801) 536-
4240.
.:Y
,,./s,:
STORAGE TAIYK PRO GRAII,TT'NDERGROT,JND
Adiusturent Forzt
i-.,.,^L;OWNER oIDate:
Facilitv* L{ffi t
(drdcocsu:)
REFI'ND DET.EIECTIARGESfor
U
Re-bilt Xles-No
2
5T =-t -
trl
oz
U
o
z
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+
q
. .qrr'= -. i :<l=.- - ' i- ltr*.S
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'rt
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-:r;r,r,ia r.,: ..
-:_a.;1- .:r.
-.t1.3:..--:'
it
trrtDt,r
ABl66/264A 15142 262-A79L I,IIMI'4ER ELECTRIC PAGE 81
WIIiIIiTEI ELECE:IIC
., LIG}EMG CO.' MC.
5330 RILEY LANE . MURHAY, UT E4107 ' PTIONE (801) 2624780
DATE !b loo
TIME:2,. ZO
FACSIMILE TRANSMISSION
COVER PAGE
TO fun v\nrner FROM!
FInfiiFIRM/DEPT !
Z
COMMENTS:
bl r.,r,t ilEUi:Dlrtll0N
EN iiir:)-*-l.uN-6m
Y
nl V\rtrovr
I
IF YOU DID NOT RECEIVE ALL PAGES IN GOOD CONDITION, PLEASE ADVISE ASAP.
ouR FAX No. rs l-801-262-87 91
TOTAL NUMBER OF PAGES INCLUDING COVER PAGE
Z6loil241a I5242 262-879L WIMMER ELECTRIC PAGE Z2
Cathodic
Protection
Arralysis
Prepared for:
Wimmer Electic
5330 Riley Lane
Munay, Utah Ml07
Utah Frcility ID# 4001279
Pleparod on:
rur f, zoo0
Prcparcd by:
Joha Labrum
Precision Testing Specialist
I I149 Sandy Gulch Road
Sandy, UT 84094
A6/86/2AOA t5:42 262-B73L I,JIMMER ELECTRIC
Tss DEte; 06/01/00
Test Numbct: (X0lflL'l
Operator: Jolm Labrrmt
Utatr Ccrtifioatc No.: UT0l48
PAGE 83
John LobranWafdtry*oaaw
I t ll9 Sundy Gtlth Ro*l
ltrlrr4', L.l't ttJ(l9J
xtt l -J9s-26{)6
ItUl -57G9925ft*t
Date: A6102100
Facility lD: 4001279
Wiruncr Ebctric
5330 Rilcy Iru
Sah l,akc CtY, tm E4107
Cathodic Probction Test
A Cgthodic protcction Test was perforrcd at the above location using thc STiPI tank nnuitor. Urdcrgrourd
stnrcture to soif !€gativ€ pot€,Dtial readiags sbouE be grcater than -.85 volts to bc oonsidercd c*maUV
protectcd.
l.*
NANANA WrappedPrssUnleadedSTIP3 Pass Stool
Sp*ialNotes:
Testcr:
86/o6l2zqa t5:42 . 262-p79L W]MMER ELECTRIC PAGE 84
lohn Ifirumwresffiiu
1I lJ9 tJundy Gulch Roed
Sandy, W tl09J
t0l-t9s-2606
501-57EE167ftu
Jur 2t, 2000
WimEbotic
5330 RihY raP
M,-.y, Uun gatOZ Uuh Ftcllity ID #4001279
Galvuic C" Tcst, silc nap and tcst bodbm. This 'rEIr ir mt to gcab'
N
cilorc9
fii,*f
fitt HtP (pll,ttt*\
Tacr 4 Pt. tr.P.1Xl
|ftrrYfY
bh,qtq
q*f
tant
- t.olD
-fu
-lo0>
-t1,c
o
DEPARTMENT OF ENVIRONMENTAL Q{JALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 Nofi 1950 West
P.O. Box lzl4840
Salt Lake City, Utah 84114-4840
(801 ) 536-4100 Voice
(801) 359-8853 Fax
(801) 536-4414 T.D.D.
Michael O. travitt
Govemor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Director
TO Wimmer Electric and Lighting
ATTN: Mellanie Wimmer
5330 South Riley 1n.
Murray UT 84L07
Sean Warner
Date: 5-19-2000
From: Sean Warner
RE: Non-compliance of underground storage tanks at 5330 South Riley lane Murray, Utah; Facility I.D. # 4001279.
The Utah Underground Storage Tank (UST) Act provides that the Executive Secretary OST) may revoke a
Certificate of Compliance if it is determined that a facility is not in substantial compliance with all state and federal
UST statutes, rules and regulations.
At the request of the Executive Secretary (UST), the Division of Environmental Response and Remediation (DERR)
performed a compliance review for the underground storage tanks at the above facility. The compliance review,
performed on 5-17-2000, indicates you have not satisfied the requirements of the Act and are out of compliance. To
achieve compliance you must do the following:
l. Submit documentation to show that you have had a qualified cathodic protection tester test your cathodic
protection system within (the last three years/6 months of installation).
The above information must be submined to this office by 6-20-2000. If it is not received by the date specified, we
will commence the revocation process of your Certificate of Compliance. If you have questions concerning this matter
or need any assistance, please contact me at (801) 536-4163.
5/19/2000 l0:20AM
a
Sincerely,
UTAH
Release
L Ownership of Tank(s)
Owner Name Facility Name
Street Address
Zip Code
Tank 2 Tank 3 Tank 4
t
I .L I
StateCity
County
7
Address s zl o S- R,
eachlor tftank.has more for additionalfacilityinformation tanks on separate lorm,
#Phone
6 2
Phone Number
Number ol tanks at facility:
Code
Area Code
oContact Person At UST Locationie
lll. Tank lnformation complere
Certificate of Compliance on site? Yes No Certificate Year:
Current year tag is displayed @", No Yes No Yes No Yes No
Tank presently in use €")No Yes No Yes No Yes No
lf not in use, date last used
lf not in use, depth ol product in tank (in inches)
Month and year tank installed a-lt-qE
Capacity of tank (in gallons)+k
Substance stored 6a<
Material of construction of tank (steel, FRP, etc.)5*,-el
Material of construction of piping (steel, FRP, etc.)5 Leel
Piping type (pressure, suction, gravity, etc.)J
ForDetectionRelease Tanks thendicate forchecklist
Method used (enter method used and complele appropriate form)'t-Tr / tt
Emergency Generator tank (leak detection defened)
tank checklists where applicable.
Method used (complete separate form where applicable)
V.DetectionRelease PFor lndicate used andpimethod(s)ng
Automatic Line Leak Detector type and model
Date of last Leak Detector performance test
Tesl result (pass/fail)
Date of last Line Tightness Test
Test result (pass/fail)
Name and company of certified tester Cert. No. UT
No leak detection required (must answer "yes" to all questions below)
Operates at less than atmospheric pressure @Q ruo
Slope of piping allows ALL product to drain into tank when suction is released @*o
Has only ONE check valve, located directly under pump Nof")
Above information is verifiable; use comments section below to document how it is verifiable
fe6u lL<
(prinl name)
Yes
I
(c
i
A
Darot 1-l 7- ee
certify that I have inspected lhe above-named facility on
Signature ol Owner or Owner's Representative Present During lnspection:
lnspector's
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner LDchecklist.wpd 2/99
Facility ,DNo. 4co I 27q
ll. Location of Tank(s)
t
2
Citv State'rh ilr rcv il r
4rA
- I rrtE9ltlrt
U
thanPleaseUsetank.all eachtor additional necessary
(tank 7 )Tank 2 Tank 3 Tank 4
ls the UST system is filled by transfers of 25 gallons or less? lf yes, spill
and overfill prevention is not required.Yes .@ Yes No Yes No Yes No
ls there a spill containment device
Conlainment sump at tank fill.
bucket <5the environment? lndicate
release of product into
, Spill bucket >5 gal
No@ Yes No Yes No Yes No
l9jherc-@qverfill prevention device installed on the tank? lndicate type
Aa{Joa(AIgnUq Automatic shutoff (in fill pipe), Alarm, or Other
(specrty)
No{9 Yes No Yes No Yes No
For overfill alarm only: ls the alarm located where it can be easily seen
and heard by the delivery driver?Yes No Yes No Yes No Yes No
For overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?Yes No Yes No Yes No Yes No
Tank 1 Tank 2 Tank 3 Tank 4
Tank5*Tank Tank Tanklndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrificial Anode
(SA), or Not protected (NP).Pplng
*5
Piping PipirE Piping
Sub-Pump Sub'Pump Sub-Pump Sub-Pumplndicate the type ol corrosion protection on Flex connectors and/or Swing
ioints: Booted (B), Total containmenl (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metailic (NM) and Not
Protected (NP)
Disponser Oispenser Dispenser Oisp€n*r
lf tank or piping has been
upgraded, indicate date
upgrades were performed:
Tank lining
Tank cathodic protection
Piping cathodic protection
The resulls of the last two cathodic protection tesls are available. (within
6 months of installation and every 3 years thereatter).Yes No Yes No Yes No Yes No
DateTank. Tester
7-
volts volls volls volts
Tester Date volls volts volts volls
Sub-Pump
volts
Sub-Pump
volls
Sub-Pump
volls
Sub-Pump
volts
DateFlex. Tester
Dispenser
volts
Disp€nser
volts
Oispon$r
volls
Dispenser
volls
{ilc-
-17-oo
No No
<-
Yes No
C Lre
For impressed current system: The results of the last three equipment Yes60operation checks are available check required Yes
lnspector's Signature
of Owner or Owner's Representative Present Duri
Yes No
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Ldspillover.wpd 2/99
a
CATHODIC PROTECTION TESTS Record results of the most recent cathodic lor each set.
(
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installed) the tank needs to
Record of last Tank Yes Yes No Yes No
lf the UST is raded the tank needs to records must be for eachbetestedI
Date of last Tank Tightness Test *'[:w 4 -2J -qR
Result of last Tank Tightness Test. lf fail, specify in comments section what
actions have been taken to correct the problem. Has DERR been notified?
Fail,@ Pass Fail Pass Fail Pass Fail
of test
(or
Name and of tank Utah Tester
used:
tester:N UT'fil[e{ le
Documentation of perlormance claims for the Tank Tightness Test method is available and shows the ability to detect leaks of 0.1 gph
with 95% or of detection and 5% or less certification
Tank 4
Yes No
lnventory volume measurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operatino day
No@ Yes No Yes No Yes No
lnventory is reconciled monthly (sum of daily over and short lor each month is
compared to 1% of tank's flow through volume + 130 gallons)
No@ Yes No Yes No Yes No
Which months exceed the allowable over-short? (specify month and year)4 5e&* qq
lnventory Control records are maintained and available for the past l2 months for
each tank
No@ Yes No Yes No Yes No
Records include monthly water monitorinq to the nearest 1/8"6)No Yes No Yes No Yes No
Monthly water readings are used to adiust monthly inventory balances 6)No Yes No Yes No Yes No
Appropriate calibration chart is used for converting product level measurement to
gallons and is available for review
Nogo Yes No Yes No Yes No
Dispenser pump has a current calibration sticker or appropriate docume ntafion /,'4 r* No Yes No Yes No Yes No
No
Yes NoAdNoYesYes Noto within orre loot of tank bottom
control methods and demonstrate
The volume of product in the tank is measured using a:6;E ATG
lf a qauqe stick is used, it is lonq enouqh to reach the bottom of the tank 6)No
lf a gauge stick is used, the bottem of the gauge stick is:Worn
lf a gauge stick is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an inch over
/7-o o
No@
h
\
ofSi
lnspector's
of
Distribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Revised 5/98
UTAH UST PROGRAM - Facitity lpno. 4 aol.27,?
Tank Tightness Testing And lnventory Control
TANK TIGHTNESS TESTING Tank 1 Tank 2 Tank 3 Tank 4
6.Yes No
INVENTORY CONTROL 6-)Tank 2 Tank 3
Please circle Yes or
6.D
6""nrrib
UNDERGROUND STOI -iE TANK PEHMANENT CLOSURE NOTr-t (Revised 01/01/97)
Facriv to # '/OO t 7 7 1
B
Closure Notice prepare d at the request ol the owner/operator (identified below) by
ol (company name
Address ity .9:- J)r/,a,,
[ ]sole proprietorship [ ]partnership I I corporation
Address
Facility Nahe
Address
A..I " /
pnone*&)/t Zf?-SJS/
stareuT zie ??ar'
state-//ZziplL282
Phone #d0/\22) - l*o
Cert. #tefiDh/ exp.a^t" 6 -99
Phone #@o/t2 {y-cl<./
Contact person
Number of regulated lanks at the facility belore closure: J
Number ol regulated tanks at the facility gftg closure:A
TANKS CLOSEO
' lndicate the specific substance stored in each tank to bo clos€d (regular, unleaded, diesel, waste oil, etc.)
Name ATANK REMOVER
Com
eooress,2.JS3 /a. 8u, /.rt Ztz. civ-So--fr2,&--stateJZz-zp ,?qa 5-
SOIUGROUNDWATER SAMPLER Name cert.*cs4le/ Eyp.da,r'. u-o0
Company pnone*tPlllt 2,1 -.ftf/
1
b
Stoto Uso O
Samp les in LUST File #
LUST Status
amples to LUST Review
Date Processed
Mailed to LHD
J/Tank #
t)k /) /(Date lnslalled
2 Dr)D 2 nnoCapacity
t/,L.Jr.l , /. r,/
g-/-gP I -/ -19Date last operated
q-)-9[q-/-9vDate closed
How closed
(Removed/ln place)QraAttr/
I
Address lu state UT zi &ya?s
FACILITY INFORMATION
tan*owner h)tmtn, F/."-y'rto pnone*tlo/t Pl 2'9730
civ 2r///Z/.- statelzt T zip st /22-
Substance stored'
CLOSUBE INFORMATION
p{ Fuel was emptied l[Strog" nk removed }( Tank was cleaned.
Tank was: [ ] Purged [{lnerted. Method Usdd:
Location of Closure Records LJt ?-/-J., ,tYl .Y, a-,.
ls any contaminated soil which was over-excavated I on-site?
-
Yes
-
No Not applicable
was Free Product encountered during closure activities? /k) tt yes, please indicate thickness,
-lnchesSITE ASSESSMENT
Complete the Facility Site Plat (Closure Notice) and Sample lnformation Table (Closure Notice) on pages 3 and 4 to show the
locations, depths, and other inrormalion on all soil/groundwater samples taken lor closure. The samples must be consistently
identified by sample lD # on the site plat, table, and lab analysis report.
lX Completed Facility Site Plat (Closure Notice) is attached.' The foltowing must be included (enter the distance, and dkeclion (N,S,E,W) lrom the atea ol contamination or, where applicable,
use OH for overhead, NP tor not pressnt): / t
Lpt^r", ui" eE{i"e, une ii*nantrai easLt -storm orrlnlL*teognone 3O B€ctdcal JL Pro;srty une -LL Buildings
[,{ Completed Sample lntormation Table (Closure Notice) is attached.p{ Certified lab analytical environmEntal sample results are attached.
[>{ Unified Soil Classification (USC) sample results are attached.
lX Chain of Custody rorm is attached.
Sampleswereproperly: [doollected [XLabeled [){Packaged [4Transported
IXI Samples were in sight ol the person in custody at all times or in a secured locked place.
I certify under penalty of law that the closure site assessment at this ,acility was conducted in accordance with R311'
2O2 (parts 28}.52and 280.72) and R311-205 U.A.C., and that any additionalsamples requked by R311-202 parts 280.52
Signature of Cenified Groundwater/Soil Sampler
-Q-,,,*,/u.s,/Date ?-aa-%
lf contamination at the lacility is conlirmed, any person providing remedial assistance lor a fee must be a Certified UST
Consultant. The Certilied UST Consultant providing assistance is:
Cert.#cc Exp. date_
Company Phone #()
Date AmountPhone #Contact NameLocation Name
q 4-gl -fank# )-1U-81r74,,, ,*tr,t f,h" /Tank(s)
flo galt-il-tI212-,ltt|o/)n-,- /d<*r- /), /Product From Tank(s)
c;-/.9r 20 g^t2<7..31/LAtttQ().- oContaminated Water From Tank Cleaning
gal/U/ASludge
gal/u//]Contaminated Water From Excavation
yd'ty /,/+Contaminated Soil
Addres State_
For ln-Place Closure: tanks lilled with
For Change-ln-Service: Substance to be stored
DISPOSAL SITES USED:
and 280.72 and R311-20&2(a)(1) were properly collected.'
Full name ol Cerlitied Sampler
CERTIFIED UST CONSULTANT Name
2
The site plat must be drawn to an appropdate idsntitied scale. lt must show actual sampling losations, substancss stored in tanks, and
dther relevant intormation. Tank and sample identilication numboE must be consistsnt with tho information given on p. 1 and 4 ol the
closure notice
Facility D* aoo /;!!71 Drawn A.J As/,.ur/u.r.y'oate ?- 30-9J)
1I Scale: 1" =Feet
NORTH
pn k )
l
GA'
(l)ta,rt c, E/.u 1,, u
F
1
I
I
I
5r
etsr?r;l
I
r.
\)
q
\
Cortn.'" 'n /
x = Sample locations (SS-*, WS+, USC-#)
l = Monitoring w€lls (MW-f,)
o = Soilbonng (SB-t), or Geoprcbe Bodng (GP{)
a = WalerW6lls {domeslrc, liv6slock, elc.)
Slop6 ol Surlace Torrc96phy: (N, NW. w, Sw, S, SE. E NE)
Land Usg Al Sile: Rssidenlial
-Commercial - lndustrhl
Surrounding kndr
-Residenlial - Commorcial - lnduslrial
SIte Plrt uuar hdhatr Actu.l Locrtiona Ol:
/ Cunonl & lormrr lar*s, pifing & dispensors
./ Ercavalionr, GW rnonitofug w6lls & soil stockpiles
/ Location &d€ptho,a[ sanples tak n
/ agiUhgs, ,6ncas, & p.opony boundari€s
/ Utility conduils (s€w€rs, gas. wai6r, storm
drains, eloclrical 6lc.)
y' Deplh lo grounclwatBr (il oncountored)
5
4
K
Analysis method(sfSubstance
stored in
tank
Sample
typet
Depth2 Compounds3Sample #/Lab lD
5 ,
z
Sas . *l a ESzt"rt 4 /.lo to,,qGrrs,s to{7Pt/Aff.lil rthiE
IIII
I I
I ut(I D ?v,NE -!l'/, vq. z
IITIIITI
II
I
I
Complete table tor all samples that taken tor closure. Sample lD numbers on the table must be consistent with
the sample lD numbers given on the site plat and ln the lab analysis report.
1 Soil (SS), Groundwater (GW), or Unified Soil Classillcation (USC).
2 Final d6pth (in feet) bglow grade at which sampl€s w6,6 tak€n.
3 Contaminant compound(s) analyzed ,or each samplg ffPH, BTE)G, O&G, etc).
4 Appropriate analysis methods,or conlamlnant compound(s) in each sample (8015 mod., 8020,413.1, etc)
State Certified Laboratory used
Address 9lo\ 1z)r"/ 7 6DD So.t.t state!2tr zipL?TZ \-(
Contact person pnone*(?0/\ 21"J-86tt
I certity under penalty ot law that I am the Owner ol the tank(s) described above and that I am familiar with the
information on this it is true, accurate and mplete and further, that the procedures described herein
were followed d tank re,
Signalure of UST
Full name of Owner
Beturn completed Closure Notice fo , Facility Site Plat and Sample Information Table, Soiycroundwater sample lab analysis
4
tl uqqtt- t
I I
j I j
,|lt
I
Ao, -,ttt,-* 2.,^
Please explain any unusual or eldenuating circumstances encountered during the site assessment or closure:
oarc l0-1-9f4
results, USC sample results, and Chain of Custody lorm within 90 days of UST CloSure to:
State ol Utah Dept, of Environmental Ouality
Division of Environmental Response and Remediation UST Section
P.O. Box 144840
'168 North 1950 Wesl
salt Lake city, utah 84114-4840
ORGANIC ANALYSIS REPORT
Client: Ashinhurst petroleum
Contact: Iack Ashinhurst
AMERICAN
Date Aaalyzed:september Og, l99g
y,'pgA,naly s is Requested:
a11a1y116a[6'laElE-ffihafr Ef
LABoRAToRrEiIoul Purgeable Hydrocarbons
kb Sample ID:
rrErrtrFGfi6a Bta*
Method Ref.Number:
TEr8467Sl60-1v5030A
@urge & Trap GC/MS)
,163 West 3500
Salt Lake City, Utah
84115
Results
= ppm
Compound:
Methyl-t-Butyl Ether
Benzene
Total Purgeable Hydrocarbons
MBDG.I/TPH-P
I
AEount
Detected:
0.002 <0.002
0.001 <0.001
0.002 <0.002
0.002 < 0.002
0.002 <0.002
0.004 <0.004
0.020 <0.020
RepgnrngLu t:
(8O1) 25$8686Toluene
Toll Free (888) 2698586
Fax (801) 25&S58Tgthylbenzene
Total Xylene
Naphthalene
Released By:
R€pon DaIe: September 10, 1998 lofl
\- \,.
ORGANIC ANALYSIS REPORT
Client: Ashinhurst Petroleum
Date Sampled: Seotember 01. 1998
ArffiRICANDate Recdived: Se:ptember 01, 1998
^,*rffiffiffig'LABOR.AiTORIESIoIaI Purgeable Hydrocarbons
Field Sample ID:
400t2?9rWIMMER
tl
Cootact: Iack Ashhhurst
Date Analyzed: September 08, 1998
Method Ref.Number:
sw'al67rr6u750'J0A
@urge & Trap GC/MS)
lab Sample ID:
t34r'.27:l
1153 West 3500 Sou
Salt Lake City, Utah
84115
Results
ComDound:
Methyl-t-Butyl Ether
Benzene
Total Purgeable Hydrocarbons
MBT)O.I/TPH-P
Amount
Detected:
Reporting
Lmut:
(801) 25&8685- .
rott rree iaaai zso-8585 r oluene
Fax (801\ 26}.8687
EOylbenzene
Total Xylene
Naphthalene
0.024 0.052
0.011 0.24
0.024 <0.024
0.024 0.029
0.024 <0.024
0.M7 <0.047
0.24 9.0
i All compouads arc reported o! a dry weight basb.
0.t%% Moisture 30.vo
Rcleased Byr
Repon Date: S€prember 10, 1998 lofl
I InT
n,
ORGANIC ANALY SIS REPORT
Client: Ashinhurst Petroleum
Date Sampled: September 01. 1998
elureqrcAr\,Date Rece-ived: Sdptember 02, 1998
ANAL.,ffiHm!*#*4*:
LABORATORIESIoIaI Purgeable Hydrocarbons
Conact: Iack Ashhhurst
Date Analyzed: September 08, l99g
Method Ref.Number:sw867rr6uv5Tl0A
@urge & Trap GC/MS)
I:b Sample ID:Field Sampie ID:
4001279 I'IMMER L344.27:2
463 West 3500
Salt Lake City, Utah
84115
Results
ru
Compound:
Methyl-t-Buryl Ether
Benzene
Total Purgeable Hydrocarbons
Reporting
Lrmit:
MBT,O{/TPH-P
Amount
Detected:
0.16
<0.014
<0.029
<0.029
<0.029
<0.057
<0.29
..,,,,*lffi]illlffiohene
Fax (80l\ 263-.8687
Ethylbenzene
Total Xylene
Naphthalene
0.029
0.014
0.029
0.029
0.029
0.057
0.29
I All compounds are rcported on a dry weight basis.
0.1%7o Moisture 42.Vo
Relered
lsor
Report Dale: Seprember 10, l99g 1of1
ORGANIC ANALYSIS REPORT
Clied: Ashinhurst Petrolenm
Date Sanpled: September 01, 1998
uwrruc^Pate Rece:ived: Se:ptember 02, 1998
o*o,#ffigpu;
LABORATORIEEoIaI Purgeable Hydrocarbons
Field Sample ID:
400127g/WIMMER
t3
Contact: Jack AshiDhurst
Date Analyzed: September 08, 1998
Method Rei. rmber:
sw'ry6-ry/cJ:vsogoA
@urge & Trap GC/MS)
4163 West 3500
salt take ciry
Results
ru
Compound:
Methyl-t-Butyl Ether
Benzene
Total Purgeable Hydrocarbons
ReponingLu t:
0.021
0.011
MBT}C.{/TPH-P
Amount
Detected:
<0.021
o.oB cv-
841r5
1801) 25&8585- ,
rorr rr* igs8i 2d$8685r oluene
Fax (801) 26!8687
Ethylbenzene
Total Xylene
Naphthalene
0.021 <0.021
0.aL <0.021
0.04 <0.044
r All compounds are reponed on a dry weight basis.
0.lVo% Moisture 34,Vo
Released
Report Date: September 10, 1998 lofl
l:b Samole ID:tr5427i-
0.021 <0.021
0.330,2t
V lr rlc
ORGANIC ANALYSIS REPORT
LABORATORIESToUI Purgeable Hydrocarbons
Field Sample ID:
4001279/WIMMER
*4
Client: Ashinhurst Petroleum
Date Sampled: September 01. 1998
o^,cplcaND.E Reciived: Sdptember Vi, lgg9
WESTAne tvsis Reouested:ANALYncALVoleEfe-Eoffi
Contact: Jack Ashinhurst
Date Analyzed: September08, 1998
Method Ref.Number:
sw*678',r6u85030A
@urge & Trap GC/MS)
lab Samole ID:BWt4-
1163 West 3500 Sou
salt take city, utah
84115
Toll Free (888) 2538585
Fax (801 ) 25&8687
Results
Compound:
Methyl-t-Butyl Ether
Benzene
(801) 25&86851o1o"o.
Repgning
Lrmrt:
MBTIOI/TPH.P
Amount
Detected:
<0.025
0.029 a<
<0.025
<0.051
0.012
0.025
0.025
0.025
0.051
0.25
Ethylbenzene
Total Xylene
Naphthalene
Total Purgeable Hydrocarbons
% Moisture
I All coEpoutrds arc reponed oo a dry weight basb.
o.t%
R€pon DaIe: September 10, 1998
43.Vo
Released By:c-
lofl
<0.025
<0.925
0.025
1.1
\-.
AMERICAN Client: Ashinhurst Petroleum
WEST Date Sampled: September 01, 1998
ANALYTICAL Lab Sample D; L34427
LABORATORIES Set Description: Five Solid Samples
Analvsis Reouested:
Unifi ed Soil Classification
Analytical Results
SOIL ANALYSIS REPORT
Method Ref. Number:
D24gg-94, x4.2
Contact: Jack Ashinhurst
Date Received: September 02, l99g
Received By: Elona Hayward
-153 West 3500 South
salt Lake ciry utah
84115
(801) 263-8585
: oll Free (888) 263-8586
Fax (801) 263-867
Lab Samole ID.:
L34427-5
Field Sample ID.:
4W17gfWimmer/#5
Classification:
Gravelly Elastic Silt (MH)
Re
USC Master
Supervisor
Report Date9lg/98 lofl
a
*LOGIN C}IAIN OF CI,STODY REPQR? (1N01)
sep 02 1998, 01;47 Pm
Login Nurnber t L34421
AccounE: ASI{100 A,shinhurst PeEroleum
Site:4001279/WIMMER
ConEacE: Jack Ashinhurst
'-34127 -i
)cl ids
L34427 -2
s<,1. ids
'-34427 -\
f1
S I'tsTXN/TPH. P
#2
S MB?XN/TPH-P
#3
S MBTXN/TPH-P
#4
S MBTN,I/TPH- P
s5
S USC
Pulge & Trap MBTE)O{/TPH
Purge & TraP I'IBTEXN/TPH
Purge & Trap MBTEXN(TPH
!\.rrge & Trap MBTEXN/TPH
Unif orm soil Classif icaEion
01-sEP-98 02-SEP-98 PA 11-SEP-98
Exprres:15-SEP-98 purge i ConEar:
0r.-sEP-98 02-SEP-98 PA 11-SEP-98
Exprres ;15-SEP-98 purge 1 conEa::.
L344?7 -3
Soi ids
L34427 -4
So1 rds
01-sEP-98 02-SEP-98 PA 11-SEP-98
Expires:15-SEP-98 purge l ConcaLn
01.-sEP-98 02-SEP-98 PA 11-SEP-98
Expires:15-SEP-98 pulge L ConEarn
01-sEP-98 02-SEP-9tt PA 11-SEP-98
ha 11 i Concarr.
Page 1
signaEure:
Dat,e I
/
AMtsRTCAN
WEST
ANALYTICAL
LABORATORIES
463 West 3600 South
Salt L^ake City, Utah
Ml 15
CHAIN OF CUSTODY
(801) 263-8686
Fax (80r) 263-8687 LAB #3't'l t?
ct rFNT .
ADDRESS
PHONE/FAX
CONTACT
QUOTET/P.O.r
zrl- sJ5/
s
Iroc4
SITE 7oolz7?
SIGNATURE
SAMPLEID
PR,INTNAME
PRINT NAME
TURN AROI.'NDTIMES
I = hiority I
tr =kioritytr
Itr=5DayRush
S = Standard
COMMENTS
a -z-2 7
#/Z
)
trl
Special Instructions:
SAMPLE
DATE/TIME
MATRD(*
7'/ t:oo I /
I I /
I V
I I /
I I V
Rccdvcd By: Slpauc
,*,*of,* / r ,4r/,.,/,, 'tsRdlnqulshed By : S lgntut Drte/Tlmc Rccelved Byz Slpavc
PRII{T NAME
Dlspetched By: Signaun Dete/Tlmc Recelved lor Leboretory py: /).L,n* ,Ud---J
PRINT NAME PRTNTNAME Cit'J^- ilr'6
A/, i?rr,, .2
Year USTs #"s
q.u)t229FACILITY I-.
certLficate of Conpliaace PRocEssrNe cIrEcKIJrsT
,w
Previous Pol-lutsion Incidents
- i.,UsT File Y/N
-- Form Included Y/N -L
*-^
4"q/
xa{
TTTrrl-- Verr- ty tank / J- Lnesvs reoisteredLDT-
- Documencation ok?
Y/N
Y/N
Y/N
+-+
- Rate oK/
Fi-nancial Assurance Fund Paid
FY 91
FY 92
FY 93
FY 94
FY 95
FY 96
FY 97
FY 99
Q1_Q2_Q3_Q4_or oz o3 Q4-
Q1_02_Q3_Q4_
Q1_Q2_Q3_Q4_o1_Q2_Q3_Q4_
01_Q2_Q3_Q4_- FY 98 _- FY 20 _
RTJ.-..
Al t ernat ive ?p1 I
Y/NI,',ees Pal-d
-FY88
-Y----7-@9
95
96
97
98
99
20
21
89
90
91o,
93
94
FY
FY
FY
FY
FY
FY
\0 Compl ianc e
- Compliance ouEstanding?
- L,eak detsection reguired?
- Spi11/overfi11 required?
- Corrosion protecEion required?
- Not.ification up to date & complete?
- Applicatsion submitt.ed?
Y(N
-
9N -'/'ltrIT IN J ALdt]j.,ZT
Y/N
-
\t-
Y/N
Date QualifiedDate Issued
Tt,Review completsed and certificate issued by
_a1l./
pslploc. frm AB/24197
qq
Pass Review? tvfi-
FY
FY
FY
FY
FY
FY
FY