DERR-2024-006416

I
MaueriHGountry
Stores lno.Maveril< Country Stores Inc.
Phone: [phone] xl22
FAX: [phone]
e-mail: [e-mail]
Monday, Januaf,y 15, 2001
Gary Astin
DEQ/ DERR
168 North 1950 West
Salt Lake City, UT 84114
Re:American Fork #301
FID #1000054
Gary,
Enclosed are the analfiical results along with Chain of Custody forms frorr the tank
removal at the above mentioned store.
If you have any questions, please give me a call.
Sincerely4/aw
Mark Christensen
Environmental Technician /
Compliance Officer
ka_&_-h
flit'ytB0,IJMtNiAL
ttt
i & ft[l}tEDtAlt0f,{
JAN , 7 200t
I
t
t
I
t,,
f
a
Work Order:
Purchase Order:
,i :,i,,-,.tr,'I.:r_:Ii R, * p.:, f !
00064r9
American Fork
1645 West 2200 South . Salt Lake City, Utah 841 19 ' 800'973-6724
July 25, 2000
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
[phone] Fax: [phone]
Mark W. Bostrom
Proiect Manager
Project: American Fork Investigation
Dear Mr. Paul Weissenbom,
Thank you for using Mountain States Analytical, Inc. (MSAI) as your environmental
information resource. Our reports are designed to meet the Certified Laboratory Reporting
Requirements of Utah Administrative Code R444-14-12(10) and the National Environmental
Laboratory Accreditation Program (NELAP), Section 5.13.
This is Report Number 0006419-l and contains 26 pages of information for the l2 samples
submitted to MSAI on Friday, June 30, 2000. Any sample receipt documentation detailed in the
Work Order Receipt Summary of this report (e.g., Chain-of-Custody, Work Order
Authorization, etc) and/or analyical results noted as "see attached " are included by reference
as attachments following page 26. For regulatory compliance reporting, individual pages or
portions of this report may not be separated.
If you have any questions regarding the information contained in this report, please feel free to
contact me at [phone] ext. 3007 or by e-mail at mbostrom@msailabs'com'
Mountain States Inc.
JAN I 7 200t
'/trn,1
I
I
I
I
\
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973-6724
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
Work Order Receipt Summary
.{l r; ;i i t,iica i Rerrri-i
00064 I 9- I
0'il25t00
0006419
Report Number:
Date Reported:
Work Order:
Received by:
Cooler Number/ID:
Thermometer ID:
Air Bill:
Packing Material:
Samples:
Carrier name:
Shipping container/cooler in good condition?
Shipping container sealed?
Custody seals intact on shippping container/cooler?
Custody seals intact on sample bottles?
Chain of custody present?
Chain ofcustody signed when relinquished and received?
Chain of custody agrees with sample labels?
Samples in proper containertbottle?
Sample containers intact?
Suffrcient sample volume for indicated test?
All samples received within holding time?
Water - VOA vials have zero headspace?
Water - pH acceptable upon receiPt?
Preservative:
Comments: AF6 labeled as AF2 (used sample times to identiff)
Shirley Chandler Date Received:
IA,ICS Temperature:
3863 Coolant Used:
Baggies
AF-I, AF-2, AF.3, AF4, AF.5, AF-6, AF.7, AF.8, AF.9, AF-IO, AF.I I, AF-I2
Hand Delivered
06/30/00 l6:05
5.3 "C
Wet lce
Not Present E
Not Applicable M
Not Present M
Not Present M
None submitted M
Not Applicable M
Yes M
Yes E
Yes I
Yes E
Yes M
Yes M
Yes M
Yes M
Yes M
Yes M
Yes M
Yes tr
Yes E
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
NoE
2
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
Sample Summary
,'lj' ,' .' .'.j i ','i ! i.-c,, i ri.j tl j.l t-.1 j r]
00064 I 9- I
07t25t00
00064 l 9
1645 West 2200 South . Salt Lake Ciry, Utah 84119 ' 800-973-6724
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
Report Number:
Date Reported:
Work Order:
Lab Sample ID Client Sample ID Additional Sample Information Matrix Date Collected
0006419-0lA
0006419-02A
0006419-03A
0006419-04A
00064 I 9-05A
0006419-064
0006419-074
0006419-08A
0006419-09A
0006419-l0A
0006419-1 lA
0006419-l2A
AF.I
AF.2
AF.3
AF4
AF.5
AF-6
AF-7
AF-8
AF-9
AF-IO
AF-I I
AF-12
Solid
Solid
Solid
Solid
Solid
Solid
Solid
Solid
Solid
Solid
Solid
Solid
06t28100
06t29t00
06t29t00
06t29t00
06t29t00
06t29t00
06129t00
06t29t00
06t29t00
06129100
06/30/00
06/30/00
3
Individual pages or portions of this report may not be separated and presented for regulatory compliance.
a
\
1645 west 2200 South ' Salt Lake Ciry, Urah 841 19 ' 800-973-6724
Report Number:
Date Reported:
Work Order:
00064 l 9- l
07t25t00
00064 l 9
,,1
,r"..-.. r:,;.i ;,. l.i-]g11i 1.r,i
Holding Time Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork lnvestigation
Sample ID Client Sample ID Date Collected
0006419-0lA AF-l
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/28/00 14:30
HT Analysis Date
07lll/00 20:59
HT
t4
0006419-02A AF-2
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/29100 09:00
HT Analysis Date
07llll00 2l:26
HT
t4
0006419-03,{ AF-3
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/29100 09: l0
HT Analysis Date
07llll00 2l:53
HT
t4
0006419-04A AF-4
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06129100 09:30
HT Analysis Date
07llll00 22:20
HT
l4
00064r9-05A AF-5
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/29100 l0:00
HT Analysis Date
0712410017:49
HT
14*
00064r9-06A AF-6
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06129100 09:45
HT Analysis Date
0712410018:15
HT
l4*
0006419-07A AF-7
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
0612910018:40
HT Analysis Date
07124/00 18:42
HT
14*
r - The recommended holding time was exceeded
4
Individual pages or po(ions ofthis report may not be separated and presented for regulatory compliance.
\
I 645 west 2200 South . Salt L:ke City, Utah 841 19 . 800-973-6724
Report Number:
Date Reported:
\York Order:
0006419-l
07t25t00
0006419
Holding Time Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
Sample ID Client Sample ID Date Collected
0006419-08A AF-8
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date IIT Prep Date
06/29100 l8:50
HT Analysis Date
07121100 2l:24
HT
14*
00064r9-09A AF-9
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date Ift Prep Date
06/29100 18:50
HT Analysis Date
0712410019:08
HT
14*
0006419-l0A AF-I0
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date IIT Prep Date
0612910018:45
HT Analysis Date
0712410019:34
HT
14r
0006419-l lA AF-l I
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/30/00 l2:50
HT Analysis Date
07114100 16:56
HT
l4
0006419-l2A' AF-12
Parameter
Total Volatile Hydrocarbons
Leachate
Start Date End Date HT Prep Date
06/30/00 l2:55
HT Analysis Date
0711410017:21
HT
t4
r - The recommended holding time was exceeded
5
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
I 645 west 2200 South . Salr Lake City, Utah 84 I I 9 ' 800-973-6724
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
i ] ,,, ;.; ' ::; ! f:! {-:';) t ):-:
Client:
Project:
Project IDI
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 r 9- I
07t25t00
0006419
0006419-0lA
AF-I
06t28t00
06/30/00 l6:05
Solid
t9874,75
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butyl ether U | 20
Benzene U 0.7 5
Toluene U 0.5 5
Ethylbenzene U 0.4 5
m+p-Xylene U I l0
o-Xylene U 0.3 5
Naphthalene 0.60 J 0.5 5
TVH-GRO C6-Cl0 u 35 100
Recovery Range
48-l6l
32-r63
42-r65
% Recovery
% Recovery
% Recovery
07llll00 20:59
07/ll/00 20:59
07llll00 20;59
07llll00 20:59
07llll00 20:59
07llll00 20:59
07llll00 20:59
07/l l/00 20:59
07llll00 20:59
07llll00 20:59
07llll00 20:59
ttdKc
ttgKg
pgKc
pgKe
pclKc
ILgKC
pgKe
TIgKE
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
100
93
96
I
I
I
U - Not detected above the MDL
J - Analyte detected below the PQL
r - Result is greater than the associated action level
B - Analye detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
6
Individual pages or po(ions ofthis report may not be separated and presented for regulatory compliance.
Client:
Project:
Project ID:
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 I 9- l
07t25100
0006419
0006419-02A
AF-2
06t29t00
06/30/00 l6:05
Solid
t9874,75
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973'6724
Mr. Paul Weissenbom
Maverik Country Stores
880 West Center Street
North salt Lake, UT 84054-29 l3
801-295-5557 Fax: [phone]
Parameter MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6.CIO
20
5
5
5
10
5
5
100
I
0.7
0.5
0.4
I
0.3
0.5
35
U
U
U
U
U
U
U
U
100
93
94
Recovery Range
48-l6l
32-163
42-r65
o/o Recovery
7o Recovery
% Recovery
01llll00 2l:26
07llll00 2l:26
07llll00 2l:26
O'l llll00 2l:26
07lLllQD 2l:26
07llll00 2l:26
07llll00 2l:26
07llll00 2l:26
07llll00 2l,26 JB
07llll00 2l:26 JB
07llll00 2l:26 JB
$gKe
TIgKE
pgKc
vgKe
pgKc
FclKc
pgKc
ttgKc
I
I
I
I
I
I
I
I
JB
JB
JB
JB
JB
JB
JB
JB
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
U - Not detected above the MDL
J - Analyte detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
'7
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
Result
I
I
I
A lnc.
1645 West 2200 South . Salt Lake City, Utah 841 19 ' 800-973-6724
00064 I 9- l
07t25t00
00064 I 9
0006419-03A
AF.3
06t29t00
06/30/00 l6:05
Solid
t9874,75
Client:
Project:
Project ID:
Purchase Order:
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butyl ether U I
Benzene U 0.7
Toluene U 0.5
Ethylbenzene U 0.4
m+p-Xylene U I
o-Xylene U 0.3
Naphthalene U 0.5
ryH-GRO C6.CIO U 35
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
20
5
5
5
t0
5
5
00
ttgKc
ttgKc
pgKc
IIgKE
pgKc
lLgKc
ttgKc
$gKc
07llll00 2l:53
07llll00 2l:53
07llll00 2l:53
07llll00 2l:53
07llll00 2l:53
07lll/00 2l:53
07llll00 2l:53
07llll00 2l:53
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
100
94
98
Recovery Range
48- 16 I
32-163
42-165
% Recovery
% Recovery
oZ Recovery
07lltl00 2l:53
07llll00 2l:53
07llll00 2l:53
U - Not detected above the MDL
J - Analyte detected below the PQL
t - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal rccovery limits
R - RPD outside normal precision limits
8
Individual pages or portions ofthis report may not be separated and presented for rcgulatory compliance.
I
I
I
a
Client:
Project:
Project ID:
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 l 9- l
07t25t00
00064 l 9
0006419-04A
AF-4
06t29t00
06/30/00 l6:05
Solid
19874,'t5
I 645 west 2200 South . Salt Lake City, Utah 84 I I 9 ' 800-973-6724
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons' Solid
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH.GRO C6-CIO
20
5
5
5
t0
5
5
100
I
0.7
0.5
0.4
I
0.3
0.5
35
U
U
U
U
U
U
U
U
94
88
94
Recovery Range
48-161
32-t63
42-165
7o Recovery
% Recovery
% Recovery
07llll00 22:20
07llll00 22:20
07llll00 22:20
O'l llll00 22:20
07llll00 22:20
07llll00 22:20
07llll00 22:20
O7llll00 22:20
07llll00 22:20
07llll00 22:20
07llll00 22:20
ttgKc
pgKe
ttgKg
ttilKc
ttgKE
pgKc
pgKc
ttgKg
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
I
I
I
U - Not detected above the MDL
J - Anallte detected below the PQL
! - Result is greater than the associated action level
B - Analye detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
9
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance'
Client:
Project:
Project ID:
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 I 9- I
07t25t00
00064 I 9
00064 I 9-05A
AF.5
06t29t00
06/30/00 l6:05
Solid
t9874,75
I 645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973-6724
Mr. Paul Weissenbom
Maverik Country Stores
880 West Center Street
North salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
,t:1 : ; ; i .,i ! !,:: g ! Rtl pt: fr.
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons' Solid
Methyl tert-butyl ether U I
Benzene U 0'7
Toluene 3.0 J 0.5
Ethylbenzene U 0.4
m+p-Xylene 2.0 J I
o-Xylene 0.50 J 0.3
Naphthalene 3.0 J 0.5
TVH-GRO C6-C1O U 35
20
5
5
5
l0
5
5
100
Recovery Range
48-l6l
32-163
42-t65
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
0712410017:49 JB
pgKc
pclKc
PgKE
p/Kc
pgKc
pgKe
pclKc
p/Kc
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
JB
JB
JB
87
96
96
% Recovery
% Recovery
% Recovery
0712410017:49
0712410017:49
0712410017:49
U - Not detected above the MDL
J - Analyte detected below the PQL
* - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery Iimits
R - RPD outside normal precision limits
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance'
l0
I
I
I
I 645 West 2200 South ' Salt Lake City, Utah 84 I I 9 ' 800-973'6724
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
Report Number:
Date Reported:
Work Order;
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
Fiupc,ri
Client:
Project: American Fork Investigation
Project ID:
Purchase Order: American Fork
00064t9-l
07/25t00
0006419
0006419-06A
AF-6
06t29100
06/30/00 l6:05
Solid
t9874,75
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 82608-UT-DERR-MOD: Total Yolatile Hydrocarbons, Solid
3.0 J
U
2.0 J
U
29
46
30
1500
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6-Cl0
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
I
0.7
0.5
0.4
I
0.3
0.5
35
89
98
97
20
5
5
10
5
5
100
Recovery Range
48-l6l
32-163
42-r65
o/o Recovery
7o Recovery
% Recovery
07124100l8:15
071241001815
0712410Q l8:15
0712410018:15
0712410018:15
0712410018:15
07124/0018:15
0712410018:15
0712410018:15
0712410018:15
071241001815
ttgKc
PgKC
ttC1KC
pelKc
FgKc
PclKc
trgKg
pgKe
U - Not detected above the MDL
J - Analyte detected below the PQL
| - Result is greater than the associated action level
B - Analye detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal prccision limits
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
ll
I
I
I
Client:
Project: American Fork Investigation
Project ID:
Purchase Order: American Fork
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800'973-6724
Mr. Paul Weissenbom
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
0006419-l
07t25t00
0006419
0006419-074
AF.7
06t29t00
06/30/00 l6:05
Solid
t9874,75
Parameter Result MDL PQL Units DF Date Analyzed AnalYst
SW-846 8260B-UT'DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butYl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6-CIO
20
5
5
5
10
5
5
100
I
0.7
0.5
0.4
I
0.3
0.5
35
U
U
8.2
4.0 J
97
86
50
2000
Recovery Range
48-161
32-r63
42-l6s
% Recovery
% Recovery
% Recovery
0712410018.42 JB
0712410018:42 JB
0712410018:42 JB
0712410018:42 JB
0712410018:42 JB
0712410018.42 JB
071241001842 JB
071241001842 JB
0712410018:42
0712410018:42
0712410018:42
pclKc
pgKe
LIgKC
tLgKc
FgKC
VgKE
ttilI(c
pgKc
I
I
I
I
I
I
I
I
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
80
92
91
JB
JB
JB
U - Not detected above the MDL
J - Analyte detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or portions ofthis report may not be separated and presented for regulalory compliance'
t2
I
I
I
.t .t
.ii{:::lt Mountain s Analvtical, lnc.
I 645 West 2200 South ' Salt Lake Cily, Utah 84 I I 9 ' 800'973-6724
Client:
Project:
Project ID:
Purchase Order:
Mr. Paul Weissenbom
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID
Date Collected:
Date Received:
Matrix:
COC ID:
00064 r 9- l
07t25t00
0006419
0006419-08A
AF.8
06t29t00
06/30/00 l6:05
Solid
19874,75
Parameter Result MDL PQL Units DF Date Analyzed Analyst
sw-846 8260&U"I-DERR-MOD: Total volatile Hydrocarbons, solid, Medium Level
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6-CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
U
U
160000 B
70000
450000
170000
20000 J
2400000
7000
5000
4000
3000
7000
3000
6000
200000
200000
50000
50000
50000
100000
50000
50000
1000000
TIgKE
PEIKC
pclKc
ttgKc
FgKc
pgKe
pgKc
pgKc
10000
10000
10000
10000
10000
10000
10000
10000
07121100 2t:24
07121100 2l:24
07121100 2l:24
01l2llQQ 2l:24
07121100 2l:24
07l2llQ0 2l:24
07121100 2l:24
07121100 2l,,24
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
Recovery Range
0 S(2r) 48-161
0 S(2r) 32-163
0 s(20 42-t6s
% Recovery
% Recovery
7o Recovery
10000 07/2110021:24
10000 07/2110021:24
10000 07/2110021:24
2r: Surrogate spike recovery was outside acceptable limits due to dilution
U - Not detected above the MDL
J - Analyte detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or portions ofthis report may not be separated and presented for rcgulatory compliance'
l3
-^.i .:, ":: ; .?rij'i., .'-
''-r: i '.1!-'i.-r, J \.-)-/i". r
Client:
Project:
Project ID:
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
\York Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Nlatrix:
COC ID:
00064 l 9- l
07t25t00
00064 r 9
0006419-09A
AF.9
06t29t00
06/30/00 l6:05
Solid
t9874,75
1645 West 2200 South ' Salt lake City, Utah 84119 ' 800-973-6724
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center SEeet
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 82608.UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
U
U
1.0 J
U
1.0 J
U
4.0 J
U
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6.CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
20
5
5
l0
5
5
100
I
0.7
0.5
0.4
I
0.3
0.5
35
Recovery Range
48-l6l
32-r63
42-t65
% Recovery
7o Recovery
% Recovery
0712410019:08
0712410019:08
0712410019:08
0712410019:08
071241001908
0712410019:08
0712410019:08
071241001908
0712410019:08
0712410019:08
0712410019:08
pgKe
ttgKc
pgKc
TIgKE
$gKe
pgKc
pgKc
pclKe
89
100
100
U - Not detected above the MDL
J - Analyte detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
l4
I
I
I
1645 West 2200 South ' Salt lake City, Utah 841 l9 ' 800-973-6724
Client:Mr. Paul Weissenbom
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
Report Number:
Date Reported:
\York Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 I 9- I
07/25t00
00064 r 9
0006419-l0A
AF-IO
06t29t00
06/30/00 l6:05
Solid
t9874,75
Project: American Fork Investigation
Project ID:
Purchase Order: American Fork
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6.CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
20
5
5
5
l0
5
5
00
I
0.7
0.5
0.4
I
0.3
0.5
35
0.90 J
U
U
U
U
U
1.0 J
U
ttgKE
ttgKc
pgKE
$gKe
ttgKc
pc/Kc
ttdKE
vgKe
0712410019.34 JB
0712410019:34 JB
0712410019:34 JB
07/2410019:34 JB
0712410019:34 JB
0712410019:34 JB
Q712410019:34 JB
0712410019.34 JB
JB
JB
JB
84
89
92
Recovery Range
48-r6l
32-t63
42-t65
o/o Recovery
o/o Recovery
% Recovery
0712410019:34
07/2410019:34
0712410019:34
U - Not detected above the MDL
J - AnalYe detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal prccision limits
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
l5
I
I
I
M -','l ,:t!',.tt.':- ir'i iii..t,-]i. ,
1645 West 2200 South . Salt Lake City, Utah 84119 ' 800-97t-6724
Client: Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Steet
North salt Lake, UT 84054-29 l3
801-295-5557 Fax: [phone]
Project:
Project ID:
Purchase Order:
American Fork Investigation
American Fork
Report Number:
Date Reported:
Work 0rder:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
0006419-r
07t25t00
00064 I 9
0006419-l lA
AF.I I
06/30/00
06/30/00 l6:05
Solid
t9874,75
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 82608-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH.GRO C6-CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
JB
JB
JB
20
5
5
5
l0
5
5
00
U
U
U
U
U
U
U
U
92
95
72
I
0.7
0.5
0.4
I
0.3
0.5
35
Recovery Range
48-l6l
32-r63
42-t65
7o Recovery
o/o Recovery
7o Recovery
07114100 16:56 JB
07114100 16:56 JB
07114/00 16:56 JB
07114100 16,56 JB
07114100 16:56 JB
0711410016:56 JB
0711410016:56 JB
0711410016.56 JB
0711410016:56
07114100 16:56
07114100 16:56
pgKc
ttgKc
pgKc
ttdKc
pgKc
ttgKc
ttilKc
ttgKc
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal prccision limits
Individual pages or portions ofthis report may not be separated and presented for rcgulatory compliance.
l6
I
I
I
U - Not detected above the MDL
J - Analye detected below the PQL
| - Result is greater than the associated action level
I 645 West 2200 South . Salt Lake City, Utah 84119 ' 800-973'6124
,,,1;31'y1tcai Repcii
Report Number:
Date Reported:
Work Order:
Lab Sample ID:
Client Sample ID:
Date Collected:
Date Received:
Matrix:
COC ID:
00064 I 9- r
07t25t00
00064 I 9
00064r9-l2A
AF.I2
06/30/00
06/30/00 l6:05
Solid
19874,75
Client:
Project:
Project ID:
Purchase Order:
Mr. Paul Weissenborn
Maverik Country Stores
880 West Center Street
North Salt Lake, UT 84054-2913
801-295-5557 Fax: [phone]
American Fork Investigation
American Fork
Parameter Result MDL PQL Units DF Date Analyzed Analyst
SW-846 8260B-UT-DERR-MOD: Total Yolatile Hydrocarbons' Solid
Methyl tert-butyl ether U I
Benzene U 0.7
Toluene U 0'5
Ethylbenzene U 0.4
m+p-Xylene U I
o-Xylene U 0.3
Naphthalene U 0.5
TVH-GRO C6-CIO U 35
20
5
5
5
10
5
5
00
TIgKE
pgKc
pgKc
tLgKg
vgKc
TIgKE
ttC/KE
ttgKE
I
I
I
I
I
I
I
I
0711410017:21
0711410017:21
07114100 l7:21
07114100 l7:21
07114100 17:21
0711410017:21
0711410017:21
07114100 17:21
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
JB
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
97
100
100
Recovery Range
48-l6l
32-163
42-165
% Recovery
% Recovery
% Recovery
0711410017:2r
0711410017:21
07114100 17:21
U - Not detected above the MDL
J - Analye detected below the PQL
| - Result is greater than the associated action level
B - Analyte detected in the associated Method Blank
E - Result is outside ofquantitation range
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or portions ofthis report may not be separated and presented for regulatory compliance.
t7
I
I
I
a
Report Number:
Date Reported:
\York Order:
0006419-l
07t25t00
0006419
,, .. ,'i ;..i i , ' i ! i-.' el .f;t,i; l, ;,r f
1645 West 2200 South . Salt Lake City, Utah 841 19 ' 800-973-6724
Quality Control Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
SW-846 8260B-UT-DERR-MOD: Total Volatile Hydrocarbons, Solid
QC Type: Laboratory Control Spike
Sample ID: 0007 I I sl Analysis Date:
Run ID: HP-2-00071IB Prep Batch ID:
07/l l/00 l3:54
R6401
Units: pgKe
Seq No: 108466
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
42.74
42.37
45.52
49.04
49.t4
85.5
84.7
45
45
48
32
42
50
50
50
50
50
t34
t37
91.0
98. I
98.3
l6l
163
165
QC Type:
Sample ID:
Run ID:
Laboratory Control Spike Duplicate
0007 I I sld
HP-2_00071 lB
Analysis Date:
Prep Batch ID:
07llll0014:22
R6401
Units: tt9lKg
SeqNo:108467
Result
44.t2
42.98
M.57
50.36
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
50
50
88.2
86.0
45
45
48
32
42
t34
t37
3.17
t.43
42.74
42.37
34
43
49
50
50
50
89. I
98.0
l0t
l6l
163
r65
U - Not detected above the MDL B - Analyte detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
individual pages or portions ofthis rcport may not be separated and presented for regulatory compiiance.
l8
1645 West 2200 South . Salt Lake City, Utah 84119 ' 800-973-6724
Quality Control Summary
Client:
Project:
Project ID
Maverik Country Stores
American Fork Investigation
Report Number:
Date Reported:
Work Order:
00064 I 9- I
07t25t00
0006419
QC Type:
Sample ID:
Run ID:
Method Blank
00071 lsB
HP-2_00071 lB
Analysis Date:
Prep Batch ID:
07/l l/00 l6:59
R6401
Units: ttgKg
SeqNo:108468
Result
45.16
47.36
48.41
Spike
Parent
True Percent
Yalue Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6-C10
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
90.3
94.7
96.8
161
163
165
U
U
U
U
U
U
U
U
I
0.7
0.5
0.4
I
0.3
0.5
35
50
50
50
48
32
42
QC Type:
Sample ID:
Run ID:
Matrix Spike
0007054-03AMS
HP-2_00071 lB
Analysis Date:
Prep Batch ID:
07llll0017:51
R6401
Units: pgKC
SeqNo:108470
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RPD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
242.1
233
233.2
224.7
3 13.5
250
250
96.8
93.2
93.3
89.9
t25
134
137
l6l
163
165
U
U
45
45
48
32
42
250
250
2s0
U - Not detected above the MDL B - Analye detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery [imits
R - RPD outside normal precision limits
trndividual pages or portions ofthis report may not be separated and presented for regulatory coripliance.
t9
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973-6724
Report Number:
Date Reported:
\York Order:
0006419-l
07t25t00
0006419
lnc.
Quatity Control Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
QC Type:
Sample ID:
Run ID;
Matrix Spike Duplicate
0007054-03AMSD
HP-2_0007 I lB
Analysis Date:
Prep Batch ID:
07/l l/00 l8:18
R6401
Units: $dKC
Seq No: 108471
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
237.3
223.r
241.6
2t5.2
285
94.9
89.2
96.6
86. I
l14
134
137
l6l
163
165
242.1
233
2.00
4.33
U
U
45
45
48
32
42
250
250
250
250
250
34
43
QC Type:
Sample ID:
Run ID:
Method Blank
000714sb
HP4_0007148
Analysis Date:
Prep Batch ID:
0711410014:47
R6478
True Percent
Yalue Recovery
Units: pgKC
SeqNo:109642
High Duplicate
Limit Parent RPD
Spike
Parent
Low
Limit
RPD
LimitParameter
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH-GRO C6-CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
88.6
94.2
97.5
l6l
163
165
Result
44.29
47.09
48.75
I
0.7
0.5
0.4
I
0.3
0.5
35
U
U
U
U
U
U
U
U
48
32
42
50
50
50
U - Not detected above the MDL B - Analyte detected in the associated Method Blank
J - Analyte detected betow the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individuai pagcr or portions ofthis report may not be separated and presented for rcgulatory conrpliarrce.
20
I 645 West 2200 South ' Sah Lake City, Utah 841 19 ' 800-973-6724
Report Number:
Date Reported:
Work Order:
.-;,' v'ir .; t i Re:ti;l'I
Quality Control Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
0006419-l
07t25t00
00064 I 9
QC Type:
Sample ID:
Run ID:
Laboratory Control Spike
0007 l4sl
HP4_0007148
Analysis Date:
Prep Batch ID:
07114100 15:12
R6478
Units: ttgKg
Seq No: 109643
Result
49
47.04
45.57
46.91
49.2
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
45
45
48
32
42
50
50
50
50
50
98.0
94.t
t34
t37
9l.l
93.8
98.4
161
163
165
QC Type:
Sample ID:
Run ID:
Matrix Spike
0006419-l IAMS
HP4_0007148
Analysis Date:
Prep Batch ID:
07/14/00 l6:05
R6478
Units: ltgKg
SeqNo:109644
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
4t.36
36.93
47.73
48.41
45.57
82.7
73.9
95.5
96.8
9l.l
t34
r37
l6l
163
r65
U
U
45
45
48
32
42
50
50
50
50
50
U - Not detected above the MDL B - Analyte detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or portions of this report may not be separatcd and presented f,or regulatory compliance.
2t
I 645 West 2200 South . Salt Lake City, Utah 84119 ' 800-973-6724
Report Number:
Date Reported:
WorkOrder:
00064 I 9- I
07t25t00
00064 I 9
IJ gi --1 ,-q .-1', t \-,1-'L.') r
Quality Control Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
QC Type:
Sample ID:
Run ID:
Matrix Spike Duplicate
0006419-l lAMSD
HP4_0007148
Analysis Date:
Prep Batch ID:
O7/14/00 16:31
R6478
Units: pgKC
Seq No: 109645
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-dS
81.4
55.9
134
t37
l6l
163
165
Result
40.68
27.97
47.74
48.7 |
45.8
34
43
U
U
45
45
48
32
42
50
50
50
50
50
4t.36
36.93
1.66
27.60
QC Type:
Sample ID:
Run [D:
Method Blank
00072lsMB
HP4_000721B
Analysis Date:
Prep Batch ID:
0712110017:43
R6610
Units: ttgKg
SeqNo: ll28l5
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RPD Limit
Low
LimitParameter
Methyl tert-buryl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
TVH.GRO C6-CIO
Result
U
U
210. l JS(lb)
U
U
U
U
U
0.7
0.5
0.4
0.3
0.7
0.3
0.6
20
Surrogates
1,2-Dichloroethane-d4 5480 5000
Bromofluorobenzene 4095 5000
Toluene-d8 5125 5000
lb: The concentration in the blank is less than 5% of the regulatory limit for this analye.
ll0
8l.9
r03
161
163
165
48
32
42
U - Not detected above the MDL B - Analyte detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal rccovery limits
R - RPD outside normal prtcision limits
Individual pages or po(ions ofthis report may not be separated and prescntcd for regulatory compliance.
22
95.5
97.4
91.6
1645 West 2200 South ' Salt Lake City, Utah 84119 ' 800'97t'6724
Quality Control Summary
ii, ;, ,: i:? ; ,i li :: ;;l fieil C;,'i
0006419-l
07t25t00
00064 l 9
Report Number:
Date Reported:
Work Order:
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
QC Type:
Sample ID:
Run ID:
Laboratory Conrol Spike
00072lsML
HP4_000721B
Analysis Date:
Prep Batch ID:
07/21100 l8:09
R6610
Units: ttgKg
SeqNo: ll28l6
High Duplicate
Limit Parent RPD
Spike
Parent
True Percent
Value Recovery
Low
Limit
RPD
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
4034
3809 B
4916
3528
4370
5000
5000
5000
5000
5000
80.7
76.2
45
45
48
32
42
134
t37
98.3
70.6
87.4
l6l
163
165
QC Type:
Sample ID:
Run [D:
Matrix Spike
00071l7-0lEMS
HP4_0007218
Analysis Date:
Prep Batch ID:
0712110019:12
R6610
Units: pClKg
SeqNo: ll28l8
Spike
Parent
U
t743
Low
LimitResult
20870
213508
24940
l 8360
22290
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RPD LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
25000
25000
83.5
78.4
134
137
45
45
48
32
42
25000
25000
25000
161
163
165
99.8
73.5
89, l
U - Not detected above the MDL B'Analyte detected in the associated Method Blank
J - Analye detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery [imits
R - RPD outside normal precision limits
Individual pages or porttons ofthis report may not be separated and piescnted for reglrl"tory cornpiiance.
23
1645 West 2200 South ' Salt Lake City, Utah 84119 ' 800-973-6724
Quality Control Summary
Clientl
Project:
Project ID:
Maverik Country Stores
American Fork lnvestigation
Report Number:
Date Reported:
Work Order:
0006419-l
07t25t00
00064 l 9
QC Type:
Sample ID:
Run ID:
Matrix Spike Duplicate
00071l7-0lEMSD
HP4_000721B
Analysis Date:
Prep Batch ID:
0712110019:38
R6610
Units: ttgKg
SeqNo: ll2819
Spike
Parent
U
t743
True Percent
Yalue Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
23730
23610B
29lL0
20460
25270
25000
25000
25000
25000
25000
94.9
87.5
lt6
81.9
l0t
45
45
48
32
42
134
t37
12.80
10. l0
20870
2 1350
34
43
l6l
163
165
QC Type:
Sample ID:
Run ID:
Method Blank
000724s8
HP4_0007248
Analysis Date:
Prep Batch ID:
0712410014:16
R6642
Units: ttglKg
SeqNo:113357
Result
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Methyl tert-butyl ether
Benzene
Toluene
Ethylbenzene
m+p-Xylene
o-Xylene
Naphthalene
ryH.GROC6-CIO
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
U
U
U
U
U
U
U
U
I
0.7
0.5
0.4
I
0.3
0.5
35
47.87
47.61
5l
95.7
95.2
102
l6l
163
165
50
50
50
48
32
42
U - Not detected above the MDL B - Analye detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
IndiviOual pages or portions ofthis repo( may not be separated and prcscni"d for rcgulaioty coiupliarrcg.
24
Report Number:
Date Reported:
Work Order:
00064 I 9- I
07/25t00
0006419
.'., t i a i y ti c a i Repir.r.
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973-6724
Quality Control Summary
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
QC Type:
Sample ID:
Run ID:
laboratory Control Spike
000724s1
HP4_000724B
Analysis Date:
Prep Batch ID:
0712410014:43
R6642
Units: pgKC
SeqNo:113358
Result
42.88
39.68
44.08
43.75
46.53
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
R1lD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
88.2
87.5
93. I
l6l
163
165
50
50
50
50
50
85.8
79.4
134
t37
45
45
48
32
42
QC Type:
Sample ID:
Run [D:
Laboratory Control Spike Duplicate
000724s1d
w4_0007248
Analysis Date:
Prep Batch ID:
0712410015:10
R6642
Units: pgKe
SeqNo:113359
Result
45.42
42.08
46.8
44.74
47.62
Spike
Parent
True Percent
Value Recovery
High Duplicate
Limit Parent
RPD
RpD Limit
Low
LimitParameter
Benzene
Toluene
Surrogates
1,2-Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
50
50
50
50
50
90.8
84.2
34
43
45
45
48
32
42
t34
r37
l6l
163
165
42.88
39.68
5.76
s.89
93.6
89.5
95.2
U - Not detected above the MDL B - Analyte detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
tndividua! pages or por iiuns ui this repon mav not be separated and presented for regtlatory compliance
25
tn
1645 West 2200 South ' Salt Lake City, Utah 841 19 ' 800-973'6724
Report Number:
Date Reported:
Work Order:
Client:
Project:
Project ID:
Maverik Country Stores
American Fork Investigation
Quality Control Summary
",. i t ri i rt {i c a i Repr:r-i
00064 I 9- I
07t25/00
0006419
QC Type:
Sample ID:
Run ID:
Matrix Spike
0007167-01BMS
HP4_0007248
Analysis Date:
Prep Batch ID:
0712410016:56
R6642
True Percent
Value Recovery
Units: FgiKg
SeqNo:113361
High Duplicate
Limit Parent RPD
Spike
Parent
U
5.126
Low
Limit
RPD
Limit
Parameter
Benzene
Toluene
Surrogates
1,2 -Dichloroethane-d4
Bromofluorobenzene
Toluene-d8
Result
t79.9
252
226.5
243.2
242.7
7 t.9
98.8
90.6
97.3
97.1
134
t37
161
163
165
45
45
48
32
42
250
250
250
250
250
QC Type:
Sample ID:
Run ID:
Matrix Spike Duplicate
0007167-0lBMSD
HP4_000724B
Analysis Date:
Prep Batch ID:
0712410017:22
R6642
True Percent
Value Recovery
Units: tt{KE
SeqNo:113362
High Duplicate
Limit Parent RPD
Spike
Parent
U
5.126
Low
Limit
RPD
Limit
Parameter
Benzene
Toluene
t74.7
162.5 R(2m)
34
43
45
45
250
250
69.9
63.0
134
t37
l6l
163
165
179.9
252
2.94
43.20
Surrogates
1,2-Dichloroethane-d4 224.8 250 89.9 48
Bromofluorobenzene 241.5 250 96'6 32
Toluene-d8 243.4 250 97 '3 42
2m: MSMSD are outside acceptable limits - LCS was within limits - rnatrix interference is suspected
U - Not detected above the MDL B ' Analye detected in the associated Method Blank
J - Analyte detected below the PQL E - Result is outside ofquantitation range
NC - Not Calculated: Duplicate value(s) are less than the MDL
S -Results outside normal recovery limits
R - RPD outside normal precision limits
Individual pages or ponrons of thrs report rnay , .^,1 l,c separated and presented for regulatory compliancc'
26
Result
/,r$..,th 198?5
Mountain States AnalYtical, lnc.Sample Chain of CustodY
(
fne QuatitY Solution
1645 ftd z0o sot t' s![ rrh cry, ucr s4l rs (&t) EI]0o50 F&\ (801) s725T
'8
wt*c Copy - oigLd Rdh by ttb Ytlo{v coPy - R't,lr b cdffi PH( Cogy ' R'lrh bv S{tIk
(
'd."--
Clicnt Nrmo /t*,w,,f
F!x
P.O.i
Prctecl Nsmr / *
S!
Phonr I
\
$
tr
N
4
o
.D
EE'oo
E
.o4t
F.
L-nqF'1
F-3
AF.,Ir.{
€-c
-7
-l
-1
Rcm!fis
frt' to
N.m. ot ShlPPcr
S.il lntacl?
ormal
MSAI USE ONLY:
ccLaE
-
CooL. TanE
-
Th.m. E
-
Wt lo., lrr lo. , ]{cr
ltnd o.x*td
-
m l C!uLc
-
6t&Fd:
-
ldr.d h glrrrho
Ccfah.: Y , t{*rY, ta rllA
C(fS*crConE:
PRESEi{f
-
tua-
aa*.n
-
itoT PRESEiII-
&*.ll rt..rtlan
YES
-
IO-
tOAa ltjo h.ad.p?YEs-ilo
-
I.|.oll:
-
thOMa{C:
-Cdrtd Co.f.h- t .d?
YES
-
NO-
Sui.l,r ArnIIa
YEg
-
ircl-
(Ru$ TAT b llq.d io MsAl .pPrqlnl lid 'tich"!p)
Fax
R
Repo( Rosutts bY: (Dat
Turnatound Time Raq uastad t br. cicb) :
PhoncRuEh rsultt toqu$tod
R€porl Ro3ultr
7d;UEEFrJrlil Itrtr trEIIII]III EIl Itn IIIIGil't/illl Ilrll llllrr
-eil III I TI lIll IIItII IIIrIld'/ll ll Ilrilll IIrIr,f,/t tl Ill rrllll[ilil1rIllI IIlI llml IIEIIT]I lr illlll IIIrIIIEIIItIIIlllllII IIIrEilllIrlIIIltmrUIIIIrilE
VWD}E'II
drgtwa
EEIIrnEtIIuTIilJlt)
s..n0b:
COC t lrb.- rBf
YES
-
llo
-
(
,/-$-.:il 19874
Mountain States AnalYlical, lnc'Sample Chain of CustodY
(
The QualitY Solution
16,5 W.ir 22oO Sqfi, Slr l'l(. Crv, Ut$ S't'lls (aT ) 973{050 F X (801) ezl{278
Whlr CoFr - Otlghd Rdh by L.b Y.Iov, CoPy- Rdrrn to Crdoffi PI* Cofty- Rrl*r b' Slrlnk
Phon. *
FtcA.k
c5
Sa
P o.#
Projccf Nam. / I
/oCliont Nems
Fax *E
€ot
g
o
o-F.oe(9CollGct dd.ioftLrtbn8.mPl.
I(,(. t
Y
Rcmrrtg
of shlppcrTim.OatcSEmplcrCinquish.d bf
Sc.l lntrcl?LabRGcaivad
MSAI USE ONLY:
CooL.D
-
CoohafrrD:
-
lhin. E
-
Wd b., al. b, t{otr.
tllrd lr.in rd:
-
ll3 l Corrlc
-
$l0r.d:
-
Lti..d h 9i09h,
Codl.lf Y , I
s-Ld: Y, il r}{A
cEC S-b dt Cona.lrr:PRelEir-
lrtd
-
atEttn
-
}EI ?RESENI-
srt!tbl
@Cf,tffltrt?
YES
-
tlo
-8.!tit , L-tsog?ils
-
t6-
vOA. i/o h.ad.fo?lts
-
fio
-
HfO.i
-
N.Ot
-
tL0Hra!rc:
-Cqttd ConbLarr l.ad?
YES
-
t{o
-suinohna qrrft?
YEg
-
tlcl
-
R-rrdr Dt'l:
Rush
Rush result3 Iaqussted Ola. dd.)
ctc
Turnaround Time Roqu $trd (!rd. dld.) :
Report RrsUlts
Phono
R.port Rslun! bY: (Oatc
(Ru.fi TAT b !d4d to MSAI lPg.qvd rn
rE6SI IEIT ITEEI IIIIEMIIIilE77,/IIIIIIIIIIIIIIrllIItIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIITIIIIIIITIIIrIIIIIIIIII I EITTIIEffiIIZ7ilMI
(
I
I
UNJERGROUND STORAGE TANK r(OGItAM
Tr
Aranttrnt
tl
os4 oooo 6;4
-1 C Date:
U ft
hJ,ADDRESS:
OWNER
REFUND Re-bill _Yes.ylilo
ol
CFIARGES
f t
-{SO $o
Reason for : ADJUSTMENT
fl5
qpao'ttti 5Z1.to
oz
EI(J
o
z
c
EI
Eoootbl b.o3
Al (L \
MrH6cr
(trREQUIRE',
M.s.q
usrADrsT (REV s/lolg3)
:.'
Rr0*rr *0-o as+ - ,i r;ibrt 'sz-7:*i: 5.os = "tt6'd,? ']:*f;fi$ir1t"fd* ''+; '
t1 :
: 3 07t94 STATE OF UTAH
DIVISION OF FINANCE
VENDOR PAYMENTVOUCHER
Accounting Period 07 lO1
FM/FY
Pr 480
v#dPovl16lWdffii
Morc Eohmtdt I l/Q!
Docr tt Number
DOCUMENT IOIAL
s8r6.87
,anE , Enorce
: INARY - Sdts/Ag$q
I \X - &ryd/Agry
Voucher Dote I 2-Jon-01
MM/DD/YY
3udget FY
Vendor Code
Vendor Nome MAVERICK COUNIRY STORES INC
Address 880 W CENTER
OI
NORTH SALI CIry UT
Cify Stote Zip
Tronsoction LD
Overpoy
V6ndor
lnvoic6
Line
Nurrbe
Fund Ag€ncy org Approp.
Unrt
Activfy Expend.
Obiect
Revenue
Source
Pro,ect
or Job
Reporting
Coteoory
Bolonce
Sheet
Accounl
Amount
r 000054 731 160 473r 731 4395 4$O(s8r 6.87
I00 4E0 1371 NAC 23r0 4no(
occomtonl
IOTAL s61 6 87
AeBmy Hcad or Aulhonzd A8€nt Appovd
Environmentol Quolity DERR
On!nnaong At.Ey/Drvisim
lS-errcyConTroifii.rm6er
84054
1
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box lzl4840
Salt Lake City, Utah 841 l4-.18.10
[phone] Voice
[phone] Fax
(80r) 536-4414 T.D.D.
Michael O. lravitt
Covemor
Dianne R. Nielson. Ph.D.
Exeutive Dircor
Kent P. Grav
Diretor
TO MARK CHRISTENSEN
MAVERIK COUNTRY STORES INC
880 WEST CENTER
NORTH SALT LAKE UT 84054
RE: Closure of Underground Storage Tanks at Maverik #301, 506 East State Rd., American Fork,
Utah; Facility ID#1000054.
A Closure Plan for the permanent closure of underground storage tanks (USTs) at this facility was
approved during June 2000. According to information provided by the Utah County Health
Department, the USTs were removed on June 28, 2000. After the closure is performed, the Closure
Notice, soil or groundwater sample laboratory analysis results and Chain of Custody form must be
submitted within 90 days of the closure. To date the Closure Notice form and USC sample results
have been received but the analytical results for the environmental samples have not been received.
Please submit the environmental sample analytical results and Chain of Custody form to our office
at the address above.
Please call me at [phone] if you have any questions.
Sincerely,
Gary
Underground Storage Tank Section
nmlosnotltr.wpd 74199
Date: lllUOI
UN ERG ROUND
Facility lD #Io0 oo 5'l
REN [ (Revised 01/01/97)
DIRR
ENVIRONMENTAL RESPONSE &
ENTERED
BY
closureNoticepreparedattherequestoftheowner/operator(identifiedbelow)by lharl< C hrisfer'tsc nt
any name)ft tt {e Y1 . Phone #(8q) q3 b- sssT
to vJest Centee S+(ec +N. sol+ Loh sratelllazip 8{os7
of (comp
Address
SEP-6
te?rocessed i)lz?lou bv /tl\
kS(- &ruu N.
se
ples to LUST Review
UST Stat
e Mailed to LHD
ples in LUST File #
FACIL rw tNFo RMATION
Tan k Owner crl
[ ] sole proprietorship [ ]partnership M corporation
Ad dress 830 UrsJ C,tt*cr Slree*
AC.Phone #, golr q36-s5s 7
b
c t Lak state-uqzip t'los7
cl L r3oFacility Name
Address 5 obE a5t 5 n citv Avlucicavr ForK state-Yll zi
Contact person Phone #
llk GK t0K (o k
Al ou_
' lndicate the specific substance stored in each tank io be closed (regula
TANK R MOVER Name Tco Kztt
Company
Address
Alan'aa I TatK I yr/1, ort
415) atst 63lo So ,,ft h City
0.-
MorCK
Pa,,r I
8{003
()
o AA
d*e ? /oo
70 - i37Ll
gLl 088
2
sot BOUNOWA TEB SAMP LER Name
,13ITank #5 b
3 /?3 b/23t
I
(>/ 86 b/ 863i23a/acDate lnstalled
leKla KCapacity
?twtF,k'tJSubstance stored
3lts /ooDate last operated
Date closed G / )o/oo
(<uo,le IHow closed
(Removed/ln plesq)
-I
-
?r o t Jct4 Cl*lte Stre t I Clty ,V. S al + LaW srate W zip X4o s4Company
Address
fr ,a tr 5 7oc5
Number ot regulated tanks at the lacility belore closure: 6
Number of regulated tanks a he facility after closure: O
TANKS CLOSED
{olt/o1
date 7/ ! lo t
,.
,1
CLOS URE INFOFMATION
/1 Fuel was emptied /1 Strog" *u. removed f Tank was cleaned.
Tank was 1,{ eurged 1vJ tnerted.Method Used:LO- / lrv ic. / AJitro-s
Location of Closure Records rn ourr;Y c
DISPO SAL SITES USED
ls any contaminated soil which was over'excavated slill on -site? _ Yes No
-
Not applicable
Was Free Product encountered during closure activities? N tt yes, please indicate thickness,
-lnchesSITE ASS ESSMENT
280.52 and 280.72 and 8311-205-2(a)(1) were properly collected.
Signature ot Cerlif ied Groundwater/Soil Sampler
Complete the Facility Site Plat (Closure Notice) and Sample lnformation Table (Closure Notice) on pages 3 and 4 to show
the locations, depthl, and other information on all soil/groundwater samples taken for closure. The samples musl be
consistently identified by sample lD # on the site plat, table, and lab analysis report.
I
lJ I Completed Facility Site Plat (Closure Notice) is attached.
The to owing must be induded (enter the distance, and direction (N,S,E,W) from the area ol contamination or, where applicable,
/ |f#"|!::;:$SJil:"t *"t*?Li).,
o""
-.,"rm
orain
-rerephone -
Ereckicer
-
property Line
-
Bu,rdinss
1'/,1 Completeo Sample lnformation Table (Closure Notice) is attached.
tJ I Certified lab analytical environmental sample results are attached.
[ .] Unified Soil Classif ication (USC) sample results are attached.
tJ I Chain of Custody lorm is attached. t t t
Samples were properly: [J ] Collected [J ] Labeled I J] Packaged ['/ ] Transported
Ir/] Samptes were in sight of the person in custody at all times or in a secured locked place
lcertity under penalty of law thatthe closuresite assessment at this facility was conducted in accordance with R311-
ZOe (parts 28d.52 and 280.72) and R311-205 U.A.C., and that any additional samples required by R311-202 parts
Full name o, Certilied Sampler erta^t I rkltag(vr aa I Date f,
lf contamination at the facitity is confirmed, any person providing remedial assistance lor a lee must be a 9glllgllUSf
Consul tant.The Certif ied UST Consultant providing assistance is:
CERTIFIED UST CONSULTANT Name uJor t.n Cert. # CC Exp. date-
ATC Assoc lJe s Phone #(
tVh,V
Compan
Address City
2
Phone #Date AmountContact
Name
Location Name
q1s - qL61 L/\a/oo Tank* l'G
a?o- j3? Y (" /rr/q l5o gatGteq yehlNTTWProduct From Tank(s)
I80 - j3av 6/7o/w , ooo galcui wr^tAITWlContaminated Water From Tank ClEaning
790-1leq b/10/.o 50 .satGta lchl
J
NryvtSludge
galContaminated Water From Excavalion
joo yd.l?J- VoeSday O.9.'f . TeohaolocicsContaminated Soil
I
ebxt t A 5 ,l
Dn<
l0b LC state UT zip 8 qpq
For ln-Place Closure: tanks filled with
For Change-ln-Service: Substance to be stored
\
A+["> St<t ITank(s)
PLAT U
must show actual samp
ers must be consistent
E
ling locations, substances stored in tanks, and
with the information given on p. 1 and 4 of the
-clL
The site plat must be drawn to an appropriate identified scale, lt
other relevant information. Tank and sample identification numb
closure notice
Facility lD #- Drawn Date
il Scale: 'l"= _Feet
NORTH
Sec c^clo1( I wl"?
X = Sample locations (SS-*, WS-r, USC-*)
= Monito ng Wells (lvflV_*,)
O = Soilbonng (SB-s), orGeoprob€ Boring (GP-#)
a = Water Wells (domestic, liveslock, elc )
Slope ol Surlac€ Topogaphy: (N. Nw. w' Sw. s. SE' E. NE)
Land Use At Slle:-Residenlial - Commorcial - lndustial
Sunounding Land- Residehlial - Commercial
-lndusl
al
Sito Plat Must Indlcate Actu.l Locatlons Ol:
y' Currenl & lormer tanks. piping 8 dispensers
/ Excavalons. GW monitoring wells & soilstockpiles
y' Location & deplh ol all samples laken
y' Buildings. lences, & propeny boundades
/ Ulility conduils (sewers, gas, waler, slorm
d6ins, elecirical 6lc.)
/ Deplh 1o groundwaler (il encountered)
3
Complete table lor all samples that were laken for closure' S
the sample lD numbers given on the site plat and in the lab
AM EI RM
y\. J
ABL EN
ample lD numbers on the table must be consistent with
analysis report,
^lState Certilied Laboratory used:
I Soil (SS), Groundwater (GW), or Unified Soil Classification (USC).
2 Final depth (in leet) below grado at which samples were taken.
3 Conlaminant compound(s) analyzed for each sample (TPH, BTEXN' O&G' eic)'
a lfpropriate anarylis meilods tor contaminant comPound(s) in each sample (8015 mod ' 8020' 413 1' etc)'
bq, w (5+ )age S o *'t h City Sr,tl Lakt
Sample #/Lab lD Subslance
stored in
tank
Sample
type'
oepth2 Compounds3 Analysis method(s)a
AF.(ua5 ,s 4',llttly't6 fa), 6 , ,o2l U
nf -7 lrl '
AF .j \l !'1'l
ftF-4 \\I .l \
AF.5 )t'l'
4 r- 6 \Cofi?
A r'-?\t4'\
nF' I I ,.{I
A( - 1 l,-t
tF-lo \I rll (
ftF'tt \,l
{l,,l t
49g.!+ gsc-{ug-4ululN lasL 6do*,* &-ccnPlon
Address
Contact person lV)acL B o 5+( o tv\Phone #( 801 \ q73- ooso
please explain any unusual or extenuating circumstances encountered during the site assessment or closure:
/a b"/
were followed during tan
Signature ot UST Owner
Full name of Owner
k closure.
Pa,^l W sls sc,^ bor vt Date DO
4
I
v1lF -t?
I
I
state ulf zip Ylllq
I certity under penalty of law that I am the Owner ol the tank(s) described above-and that I am familiat with the
intormation on this torm and that it is true, accurate and complete and further, that the procedures described herein
Fteturn completed Closure Notice lorm, Facility Site Plat and Sample lnformation Table, Soil/Groundwater sample lab
analysis results, usc sample results, and chain of custody form within 90 days of UST Closure to:
State of Utah Dept. of Environmental Ouality
DitiJio; ;f Enti;Snmentai nisponse and Flemediation UST section
P.O. Box 144840
1 68 North 1950 West
salt Lake city, utah 84114-4840
Maverik #301
American Fork, Utah
Facility lD# 1000054
USC Soil Sample Description (Geologist Evaluation)
USC.1
Silt with 5% coarse sand, brown, no odor, dry, (ML)
USC.2
Cobbly sand, poorly graded, 10-15% cobbles, cobbles to 4 inches diameter, tan to brown, very
slight gasoline odor, dry, (SP).
USC.3
Clayey sand, well-graded fine to coarse, 15% coarse, brown, no odor, moist, (SC)
USC4
Sandy silt, 5% medium sandn gray, no odor, slightly moist, (ML).
Evaluated by:
Paul Weissenborn, P.G.
Environmental Manager
Registered Professional Geologist
Certified UST Consultant (#CC0086)
A%*;z
\----
G
S
neighborhood: (check the best description of land use)
! industrial/commercial Other-Surroundino
lff residentiai
Zip
Facility Name
_City
_Street Add
XIOQ
Name
Tanktlo.Srank tlo. L{ranr No.5Tankruo. I ranr ruo.O
lnK(,KktK,'K 6K1. Estimated CaPacitY (gallons)
6\)553S2. Type (d{&1, rne, Composite)
6G6GG
1:ts-,5-ffB-5-(T)tB-L5'6o?ri-cr1B-tq- tT:.
3. Substance Stored
4. Date last used
CTo-&,<t,rfn-iq-,^|)(p -ffi-{ry\Clr't"&lF,'Yo -c7B'dD4. Date Closed
ace, CIS5. How closed
Expiration Date:Cert. #:GSGW & SoilSamPler:
ExpirationCert. #: TR
UST Remover:
is on Site NN CoPY of closlre
1. Owner/OPerator closurehasanapproved
2. Product removed:at:By:
3.S removed:
nsate disPosed at:By:4. Tanks cleaned:
LEL or
inside tank obtained
ned:lne
5.
-P site:Removed,andCleaned,secured in6. Product lines were: --
8. Soil
7. Tank
site:
site:
Calibration sPecs
Meter
PID or FID meter readings (indicate location on the site plat.):
Gain or
than 3leet
Y of contamination:0-3 feet-_
1. Soil evident:is
N
direction of surface
wateto
2. Water
Yevident:is
3.#of
USCSoilGW
4.Certified Lab:
o&G TRH HOC
EXN
Methods5.on the siteol
N lndicate location andY
6.1 observed collection of
collected7
and
forLabtheStatetothem
tf
soil
YN
were collected: Y N
Revised 5/98
UTAH UST PROGRAM . -cility to nod(IiQ2f
Permanent Closure lnspection
ll. Location of Tank(s)vfl. Ownership of Tank(s)
Rr-nrzr^\LY\rn )rt?rfl\ABnnrA?rnrr\
8.
CLOSURE INSPECTION SITE PLAT
NORTH
ID
SYa "lc S'f rcrT
e I
t aPr-'v'x
L
\:5 C )?1
*ry.,l
os
nl l4n^.
'VrlY
' tb SOAP-'ffi i
sr;Fb
x r Crr
t0Ath
x
Show all buildings, streels, lanks, piping and dispenser islands. lndicate location Also the
51ot e
Potential Receptors: Distance (in feet) to the nearest:
Residences Commercialbuildings 'ylC
Surface water _ [Jnderground: Sewer
Telephone line_ Electrical line _
Property line_
Water line_
Storm drain_
/o
Other
Active water well _
Natural oas line
ICom
U--7
A
corr-ccsr$
r---7t
€D nF-G (-r.rrs o
( monlh, day, year, lime)
l1)I
a
name)
ijDate:
r Dl!evM Srnc|l , ,V<;l clr.e
certify that I inspected the above-named lacility on
Yellow-lnspector, Pink-Facility/Owner Revised 5/98
AG T L '-e!AN (rev. 10/04/99)FACILITY IDf loooo 5
Y
ate Received 6 ^lL{
ate Received te Mailed to LHo
eviewel te Received From LHD
ate LHD Approved eviewer/Date APProved
te mailed to State . ReviewDate
ln€/e5€.'/6o,a,t/
D ND
Closure Plan P
of (comPanY name)u
8o
repared at the req uest of the owner/operator (identilied below) by K Chri:ft ng€ il
5totr T ac.Phone #q -55 1. tll
+tcct City N "ll stare uT' zip 610s1
/+uc
lVl^,
AcontractormaypreparethisClosurePlanastheowner/operator,saoent.lnpreparingtheclosurePlan,thecontractor
must acr w*h the o*n",/op"r"tol'#ffi;;; *i #rou"i. rn" o*n'.tloperaior must sign the Closure Plan'
This closure ptan is submitted in compliance with the requirements contained in 40 cFR 280 subpart G and R31t-204
(u.A.C.)
FACILITY INFORMATION
Tank Owner 0r4
I I sole Proprietorship [ ] partnershiP [vt corPoration
Address x(o r^i ,/$(c S-t rtct
Phone#( 3ot) q)6' ittT Y loa
City
I
IU 5e ft l^k State \/tT zip $4ol4
City ric"state Ltr zip E{oo 56,
fe o
Facility Name Ma \rtf if
Address to
((
4tf{
IContact Person
Total number ol regulated underground tanks at this site
Total number ot regulated underground tanks at this site
: lndicate the specilic substance stored in each tank to be closed (regular, unleaded,,iesel, waste oil, etc )
For waste oil tanks: Have degreasing or othe r types ol solvents been stored or mixed with the waste oil?
No Not known --
Yes (identily if known)
be required prior to disposal of contaminated soil or other material' (Check wlth
Analys is for lead or other contaminants may
(,
to be closed G
Tank #
Tvp e (Steel,FFlP,etc.)
Date lnstalled
(
5lr<1
(o Xc
a
5fttl
j
S1-"tI
c/Eb
51<r l
o/sb
5
Sktl
3h3
G
glee (
,/t3
CapacitY
Substance stored'
\lh
lr J
\eb
(rrM
}K bK
P rc^
toF
NL [)lcu I
6
Date last operated oo
pr^ro Jtl
c.n
((vrnovf I
6
{tvrno0r J ({vrnnvr J
Removed/ln Placei
Chan e in Service?
{{uhoJt}.(?rr*otr I
your di sposal facilitY.)
1
Address c
il
TANKS TO BE CLOSED
phone # ( 8ot ) ?56'?377
q
)/? 3
loK
NL
3/tt/oo
TANK BEMOVER Name ''al I
Company t,crr,
c r---lolo4 e*o. aare?/ oo l
- ffin" *6at \28O33Aq
Addtess t/15} l^./.f,3-7 0 S.
SOIUGROUNOW ATER SAMPLEB Name ?a^l ?. vJctstraLqq
a|/((i 7ac.
City h/..s| Co, da^State at zip HosS
c
Cert. #GS 5t{Exo. date 7/t /ot.-----f----t-
Phone*lqoll q3c'sss) )t tp7Company
Address 88o \J t<t Crr*r sltu+ru. 5.ll ,ah stare u,T zip 440s4City
Belore the closure plan is submitted for approval, the local health and lire departments where the facility Is located
must be Contacted. tl the lacility is in Beaver, Carbon, Emery, Gaiield, Grand. lan, Kane, SaI Lake, San Juan, Wasalch, or Washinglon counly
contact DERR (JSD at (8Ot)536-4100 instead of the local health dislricl. You stillnusl conlacl lhe local lirc deoartment in lhese counlies.
CT LOCAL HEALTH DISTRICT Name of Dist Date 5 ooCONTA
Contact
CONTA
Contact
cr LozLFtR
t h Tifle Phone# 37O'8775
. ErA Date
Tifle fir, fiqrl/l Pnone* 7L3-3dS
E DEPT. Name of De pt.
Tank(s) will be disposed at: Facility hl/,,' 5k<-(
Address b8{ €. 2oo N.Ci Provo stare U7'zip
Contacl person
Product lines will either be: / ,"rorud or
-
cleaned, secured in place, and capped.
Vent lines will either be: / r.urnou"d or
-
cleaned and secured open.
Phone#60l \ qTS4LLT
tlaPiping will be disposed at: Facility
Address €4h€City srael,/T zip-
Phone # (8O /\ ?7€-7LL?
Phone #a%t sso832r
Phone * {tot t
"o
-732q
Tank(s) will be emptied by: company
Tank(s) will be cleaned by: company
Contact person
Contaminated
Contact person
Tank(s) will be
^/7fl/V?f/
water
Gr
in the tanldrinFate will be disposed at: Facility
,(")/
A/m
- r/purgedor /rendered inert by the lollowing method:ZO
I sludges will be disposed at the following facility:/V77?
4s 4bor<City
Phone #fr/-$) 4
Hesidua
Address
Contact person Phone #
FOR CLOSURE IN.PLACE ONLY
[ ] Approval for in-place closure has been granted by the Local Fire Department'
Fire Dept Phone#- Con Date_
[ ] Approval lor in-place closure has been granted by the Local Health Deparhent'
Phone#- ContactHealth District Date_
2
DISPOSAL INFORMATION
state_ zip-
\
A
A.ll materials generated from UST closurv. rrll,.ror be managed and disposed in a manr, .h. ro€S not place those materials
in direct contact with the environment. On-site stockpiling of contaminated soils may be required prior to any soil
management activities. Any person providing remedial assistance for a fee, including aeration and over'excavation (of more
than 50 yd), must be a Certified UST Consultant.
Contaminated soils generated as part of tank removal are to be disposed at the lollowing facility
ET.fr tJ 3o s City wt/c
statel lf zi Contact pe b"Phone #8o/ \ ?7?-2aAd
SITE ASSESSMENT
A site assessment must be performed for all UST closures and change-in-service. Site assessments must be
perlormed as ouilined in 40 CFR 2g}.Z2and R311-205 (U.A.C.1. lf contamination is suspected. additional samDles
must be collected at the location where contamination is most likelv to be present. lf qroundwater ls encountered.
" soil samole mustffirated zone. in addition.to-ea,ch qroundwater samDle. soil and
[zeofortn-compoundsshownintliefollowingtable,usingappropriatelab
methods.
Substance or
Product Type
Contaminant Compounds to be Analyzed ANALYTICAL
METHODS
Soil, Groundwater
or Surface Water
Gasoline Total Petroleum Hydrocarbons (TPH);4! Benzene, Toluene,
Ethyl benzene, Xylenes, Naphthalene, (BTE>N) and MTBE
EPA 80l5B t and EPA
8021B t or 82608
Diesel Total Petroleum Hydrocarbons (TPH); 4{ Benzene, Toluene,
Ethyl benzene, XYlenes'and Naphthalene (BTEXN)
EPA 80158 and EPA
8021B or 82608
Used Oil Oil and Grease (O&G) or Total Recoverable Petroleum
Hydrocarbons (TRPH); and for
benzene, Xylenes, NaPhthalene
Benzene, Toluene, EthYl-
(BTEXN) & MTBE;and
Volatile S
EPA 1664 or 5520 2
and EPA 8021B or
82608
New Oil Oil and Grease (O&G) or Total Recoverable Petroleum
H;drocarbons tTRPH.l
EPA 1664 or 5520
Other or
Unknown
Total Petroleum Hydrocarbons (TPH); 4! Benzene, Toluene'
Ethyl benzene,Xylenes,and Naphthalene (BTEXN)r and
latile (VOC So
EPA 80158 and EPA
8021B or 82608
t The following modifications to these certified methods are considered acceptable bY the Executive Secretary (UST):
A.Dual column contirmation maY not be required for TPH & BTEXN/IITBE analysis'
B A micro-extraction or scale-dow n technique may be used for aqueous samples'
C. Hexane may be used as an extraction solvent'
NorE: The sample preparation method and any modification(s) to a certified method must be reported by the laboratory on the
final analYtical rePort.
2 Methods or resr procedurei allowed for oil and Grease (o&G) or Total Recoverable Petroleum Hydrocarbons (TRPH) are 5520(b) or 5520(0
respectively.
Complete the Facility Site Plat and Sample tnformation Table on pages 4 and 5 to provide site assessment
information.
orconfirmed,theinformationmustbereportedtotheExecutiveSecretary(UST)
at (Bo1) 536-4100 within 2i nours tne DiGion of water ouatity'must oe notified at [phone] if Free Product is
encountered or if surface water has been impacted. lf contamination is confirmed, any person assisting in the remediation
process for a fee must be a Cedified UST Consultant'
3
FACILITY SITE PLAT (CLOSURE PLAN)
The site plat must be drawn to an ap. .ori"E ii-ml'iii6EJcale. lt must snow ptann' ' ;ar''nling locations, substanc6s sto/ed '
in tanks, and other relevant informa\-,. 1-.rk and sample identification numben--u1-,e coosistent with the inlormation '
given on p. 1 and 5 of the Closure Plan.
Facility lD #- Drawn Date-
1I Scale: 1 = _Feet
NORTH
tee r?rT4cU€O
X = Sample locations (SS-#, WS-#, USC-#)
o = Monitoring Wells (MW-#.)
O = Soil boring (SB-#), or Geoprobe Boring (GP-#)
It = Wster Wells (domestic, livestock, etc.)
Slope of Surface Topography: (N,NW,W'SW'S'SE'E'NE)
Land Use At Site:
-Residential -Commercial -lndustrialSurrounding Land:
-Residential -Commercial -Industrial
Site Plat lVlust Indicate Approximate Locations Of:
y' Current & former tanks, piping & dispensers
y' Location of all samples to be taken
y' Buildings, fences, & Property boundaries
/ Utility conduits (sewers' gas, water, storm drains,
electrical, etc.)
4
PLE INFOFT TION T
Complete table for all samples to be te osu re.
1 Soil (SS),
2 Approx. depth in leet below g
Groundwater (GW), or Unilied Soil Classifcation (USC)
rade. The required minimum site assessm ent samples must be taken at O'2 feel below lhe backtill/native soil inlerface
3 Contaminant compounds to be analyzed for each sample (from table on p.3).
4 Appropriale analysis methods for contami nant comPound(s) in each samP le (lrom table on P. 3)
Approximate depth to groundwater in the vicinily of the tanks:
Regional groundwater flow direction:
State Certified Laboratory to be used
SSW .5 |tl t^c .
3 t feet.
City S"l L"state uT. zip ?'/l(1
Phone #0 -oo o
Contact person A.ndrV Bol oc
PleaseexplainanyunUsualorextenUatingcircumstanceSexpectedregardingthesiteassessmentorclosure:
Fx,'s lirt /.A. t 7. C'Tu
herein will be followed during
Signature of tank owner
Full Name of tank owner
I certity under penalty ol law that I am the owner/operator ot lhe tank(s) reterenced above-and that I am famillar with
the tnformation on this torm 2|jil;i ii Liru", acturate anO compreid, and lurther' that the procedures described
5
Sample #Substance
stored in
lank
Sample
typet
Depth'z Compoundsr Analysls method(s)'
utc-l+ 0sc'y'4ose/'hc use-3.r/, z LtSC /o tbl cn rt-
<s-l + ss-3 SS 83.{B?q,/,r4l,rffi 3otS8. ?2LL6
-4 t ss't
s S-8-: Ss - ?
I S5 /3
ts 7.{
-lo.+ Ss- /3 Ss /3
k closu
lore Tac.Date LJ2-oo
looress IU''15 Wrrt ftoo Jooth
t
4rtSS*
sheer
(JlOO
rrl
a
-la
n
rTIrrl
-{
/oX6
Oo
\oo
g
F
2
UI4
3
ildonel Tank and tonltorlng
a$a1,190p
!4!!!d(ilor!fpl
l,laUonal Tank and Monltorlng
Connect ilorth Tanks & Flll l-ineri into Exlstlng CP System
Strdon
I
2
3
4
5
6
Tlnk
SflIt tlnlead Tanf
Snrth MdgradeT{nk
South Premiuq Tant
Nirm LhbodTatrk
Nore MdlrEd-eTa4t
Norlt Prpmirrm T:rnk
Voltrge Potpntiql
efterNo TanksConn.ffi
1387
1386
13E5
W
971
1005
volhgoPotentilt
beforo Na Tanks Conn.
t: ll' -r I
LZ86
L?42
l3o4
sg8
6?2
608
Comm64ts
Rect.Opsrahng@ l.OV t ?,0 A(Before)
i.eet. Opoating@ 7.5V t2.2 A(Aftor)
)
R
\\
\q
\_
I
i
!
t,
I
lUaverlck Stoie *fOt
Gonnec{lon of ilor$ Tanks to Exlgting CP Systom
It600
100
200
000
800
q00
400
?00
o
1
Eto,E
SEtc
E=
1
1 -+--After Nonh tanke Connected
--r-Eefore NUth TanfS @nneeted
-Minimum
crileria (850 mv)
South
Unlead
Tank
South
Midgrde
Tank
Sorrth
Premium
T*rk
North
Urilead
Tank
Nodh
Mi@made
Tank
North
Premium
Tank
)
UTAH UST PROGRAM
ln
ID
ist
l. Ownership of Tank(s)il.t
Owner Name 301
Zip Code
Area Code Phone Number
Contact Person At UST Location Phone #
*
Address 5
StateCity State zip
Year:
b
City
Facilitv Name l*A n t x_o E *l-,
Certificate of Compliance on
Street Address
County
Tank 1 Tank 2Number ol tanks at facility:
v^^ it^./Cufienl year tag is displayed Yes
-LaA
Nn Nla\ Tank presently in use (%)-nr +
ll not in use, date last used
ll not in use, depth of product in tank (in inches)
Month and year tank installed lqt3'-t1E6*
Capacity ol tank (in gallons)A rlk
-
toK (?K (r(
Substance stored (*)Plwe a4aqr I l*\ l!u-.ffi6
Material of construction of tank (steel, FRP, etc.)Sfail--Uwt-,
Material of construction ot piping (steel, FRP, etc.)YP.P
-
;
Piping type (pressure, suction, gravity, etc.)h^ o -aAt-La-t* \--
=lV. Release Detection For Tanks lndicate the method(s) used for eJch tank. Complete the appropriate checklist lor each method used.
Emergency Generator tank (leak detection delerred)
Melhod used (enter method used and complete appropriate form)3tQl
-
2
V. Release DetectiOn For Piping lndicate method(s) used and complete appropriate tank checklists where applicabt
-I\tlethod used (complete separate form where applicable)->/automatic Line Leak Detector type and model t{v
I Date of last Leak Detector performance test D rltilqq -
Test result (pass/fail)'D-r^->
Date of last Line Tightness Test
Test result (pass/fail)
Name and company of certified teslet *E q Cert.I 'tot)tNo. UT
No leak detection required (must answer'yes'to all questions below)I
Operates at less than atmospheric pressure Yes No
Slope of piping allows ALL product to drain into tank when suction is released Yes No
Has only ONE check valve, located directly under pump Yes No
Above information is verifiable; use comments section below to document how it is verifiable Yes No
inspected the above-named facility on
(lMth. day, yod, tm)
n certify that
Signature of Owner or Owne/s Representative Present During lnspection
lnspecto/s Signatu
Distribution: White-DERR, Yellow-lnsp€ctor, Pink-Facility/Owner Revised 2/4/99
Release Detection
No. l0O O os4
5ol Ll '
lll. Tank lnformation Complete lor each tank. lf facility has more than 4 tanks, complete information for additional tanks on separate form.
aTa k* /,ft,
lulUrr.&.r-*ffiJvv\-e/r-l
"va4* ltbo,
-
UTAH UST PROGRAM
Overfill and Corrosion
for each tank.lorms as necessary iI the lacility has more 4Please
Tank 1 Tank 2 'a Ta rr.e.4 <;. Tar tk* h
No YesY"{B-N,b\
-
The UST system is filled by transfers ol 25 gallons or less. lf yes, spill
and overfill prevention is not required.
Yes No
t\
-Yes
Ar lFls there a spill containment device that will prevent release ol product into
thqenvironmenl? lndicate type: Spill bucket <5 gal., Spill bucket >5 gal.^
dntainment sump at tank till. I
NolslNovNo
,NO
7
t ls there an over
.,6(ttlo^t(in venr
r (specily)
ilthe tank? lndicate type
or Other
YesYes No Yes No No Yes NoFor overlill 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 NoFor overfill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
Tank 1 Tank 2 Tar k3 Tar k4
Tank '- AIP fi >?Tank
7-
ng PilPipingPir lseAI
Piping
AA
lndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrilicial Anode
(sA), or Not protected (NP).
Sub-Pump Sub'ump Sub-t- Sub-PumoNIU -
,mp
0isp Disp{rs€r+' oispensetAt,4 Uo//\p*
Dispenser
V,h\*rLt'afu'
lndicate the type of corrosion protection on Flex connectors and/or Swing
joints: Booted (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metallic (NM) and Not
Protecred (NP)
U
lf tank or piping has been
upgraded, indicate date uPgrades
were performed:
Tank lining
Tank cathodic protection
Piping cathodic protection
rt.-.cord the lowest
Nln Nn-)YesThe results ol the last two cathodic protection tests are available. (within
6 months of installation and every 3 years therealter)
volts volts voltsvolts
DateTank. Tester
volts voltsvoltsvolts
Tester
I
Date
Sub I ump
volts
Sub{ump
voltsvolts
Sub.Pump
volts
Disp€nser
volts
Disp fnr",
volts
Disp nset
volts
Dispenser
voltsDateFlex. T
Yes NoYes No Yes No Yes NoIFor impressed current system: The results of the last three equipment
operation checks are available. (Equip. chegk lequired every 60
rolzcled
Durin
o
5
a
-t 6,utla 4
lnspector's Signatu
of Owner or Owner's
Distribution : White'DERR,Pink'Facility/Owner Flevised 2/4/99
Facility 1s 11s.tOo O O94
Checklist
Yesffres- I No\_--
ly
:h lanldpipinq/flex sCATFIODIC PROTECTION TESTS Record results ol the most recent cathodic protection test.
-
@
/\
Sub-Pump
SIR as a method of leak detection refers only to monthly monitoring using SlR, An annual test pertormed uslng SIR is considered a tank tightness
test and should be reported on the tank testlng and inventory control torm.
Name and address of SIR vendor:t^sT74 +.i)
P
Yes No
lnventory records lor product inputs, withdrawals, and the amount stlry ^f-lremaining in the tank are available for each operating day. /Y -Yes No Yes No ,T No
Records include correct number of monthlv water monitorlnq readinqs.v"" /n0 YES NO Yes No
Tank inventorv is measured and recorded before and after each fuel deliverv,Yes No Yes No Yes No
Approprlate calibration chart is used lor converting product level
measurement to qallons and is available for revlew.
Yes No Yes No Yes No
No
No
€No Ye!NoDispenser pump has a current calibration sticker or appropriate calibration
documentation.
---{erlltrr -4fE!-flF6)*-vtr ru;>ftrc drop tube in the fill pipe extends to within one foot of tank bottom
SIR monitoring records are available for the past 12 months. lf no, indicate
which months are missinq in the comments section below.v"" 6o)YES NO Yer No
NoYes Yes No Yer No No
"1"
Are any months results reported as "fall"? lf yes, specify which months ln
comments section below.
No NoAre any months results reported as "inconclusive"? lf yes, specify which
months ln comments section below.
Yes No Yes No
@ No
Documentation of performance claims for the SIR method is available and shows the abllity to detect leaks of
0.2 gph with a 95c/o or greater probability of detectlon and a 5% or less probabillty of lalse alarm (3rd party
certificatlon).
No3rd party certlfication indicates the method has been approved lor both tanks and lines.
ATGlThe volume of product in the tank ls measured using a:\__-
Yes Nolf a qauqe stick is used, it is lonq enouqh to reach the bottom ol the tank.
Acceptable Wornlf a oauqe stick is used, the bottom of the qauge stick ls
Yes Nolf a gauge stlck is used, it is marked legibly and the product level can be determined to the nearest 1/8 of an lnch
over the lull ranqe of the tank's internal helght.
:
the approprlate sections of the ATG checkllst., Art lz a;-*^ +"^fuA 1".0 Ae s s/t, lqt *+L w^aa-e/
Signature ol Owner or Owner's Representative Present During lnspection
I IU
Date:lnspector's
l Complete
Comments
Oistribution: White-DERR, Yellow-lnspector, Pink-Facility/Owner Revised 5/98
Facirity tDNr. iA O 0 O54
Monthlv Statistical Inventorv Reeonciliation (SlR)
UTAH UST PROGRAM
Please circle Yes or No for each question for each tank Use additional lorms as necessary if more than four tanks.
Tank'l Tank 2 5'l^,E*4 S rlnr:r /,
Y"L
'+
L:7'-
Ye +"
I
\tl P.O. Box 52045
Phoenix, AZA5O72-2OA5
602.728.4OOO
T(EDSGCD
MarketingCompany
DERR
ENVIRONMENTAL RESPONSE & REiliEDIATI O}!
ENTERED
MAY I 4 1999May 11, 1999
Mr. Kent Gray
State of Utah Department of Environmental Quality
Division of Environmental Response and Remediation
Salt Lake City, Utah E4114-4840
BY
RE: Suspected Releases Reported May 11, 1999
Former Circle K Store f184, Facility ID # 1fln054 and
Former Circle K Store #12m, Facility ID # 5fin040
Deer Mr. Gray:
Pursuant to 40 CFR 280.50 and 280.52, your agency was notified of a swpected releases at
the above facilities within 24 hours of discovery. Notification was necessitated by the two
consecutive months of inventory discrepancies. Circle K was the owner/operator during
the months of March and APril 199.
Circte K is not allowed to test these UST systems because they were sold to Maverick
Country Stores, Inc., effective April 28r 1999. Maverick tested all tanks at former store
#1290last week and is teting all tanks at former store #7E44 today. I anticipate they will
provide a copy of the test results to your agency.
Respectfully
fu,oA
Ruth H. Bulmer
SW Region Compliance Specialist
ts@res
ur/l RELEAsE REPoRT t^RM
(CRBATED rCrR lI{-}IOt SE PURDOSEs ONLY)
cer.r, laoi;surm - ExEcurIvE SEcRETARY (usr)
frY 35,. ffSJ
REPoRTING DATE: -9.@,EB3&-@
STORE INFo: -sToRE
i7sa4, FACILITY ID tlm)64-
-sffi E. STATE, AMEnICAN roRK
PRODUCT:
(trnk or lln.)
UNLFADED G ASOLINE SYSIEITL-
REPORTED TO:STATE OF UTAH, DEPT. OF ENVIRONMENTAL QUALITY
(E01)sgloo, uEcuTrvE SECRETTARY (Usr)
DATE |. L0l2alE7-vl[
CASE f,:
(ut*n.,'t, E coNnRMED
STATE OFUTAII, DEPT. OT ENVIRONMENTAL QUAIJTY
ow. or mrrR QUAtIfi 0F WATER COI\mAMINATION)
(Em)t3&6116, CoNTACT:-VA-...--
DATE
CONSTLTANT: IVA--
UST OWNI|R:
USTOPERATOR:
CONTAC'T:
ADDRESSi
PHONE:
INITIA
DESCRIPTION OF INCIDINTr
BE SCIIEDULED.
RECONCILIATIONER STATISTICAL INVENTORYIAII.ED SETTEMB
DISCOVERY DATE: OCTOBER Zl AT {PM(sIB) ANALYSIS.ECUTryEf,EM FAIL OCToBER ANALYSIS ( 2 CONSSHOULD THIS SYS STWILLBE NOTIFIED AND A UST SYsTEIIITEMONTHS), YOUWIL
80'd 900'oN L0:II 2-6,82 l1O : (I
TOSCO MARKI]TING COMPANY
CIRCTE K STORES TNC.
RUTHBUTMER
P. O. BOX 52lt6l, PITOENIX, ARIZONA t5072
(@zl2oI.4gtt [AX: (602)53G3113
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
(80t) 536-,{414 T.D.D.
Michael O. Leavitt
Covemor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Director
TOSCO MARKETING COMPANY
3550 N CENTRAL AVE
4TH FLOOR
PHOENIX AZ 85012
October 29,1998
Re: December 2211998 upgrade deadline for Underground Storage Tanks
The Division of Environmental Response and Remediation (DERR) records show you have one or more underground storage
tanks (USTs) which have not met the December 22, 1998 UST upgrade requirements. These tanks are located at CIRCLE K
#7844,506 E STATE, AMERICAN FORK, facility ID# 1000054.
Under Federal regulations issued in 1988, UST owners and operators have until December 22, 1998 to upgrade, replace, or
permanently close USTs that do not meet the requirements for protection against spills, overfills, and colrosion.
This deadline will not be extended. If your tanks are not in compliance by the deadline, they will not be able to receiYe
deliveries of fuel.
Our information shows these requirements have not yet been met:
Tank ID
I
2
J
4
5
6
Substance
Gasoline
Gasoline
Gasoline
Gasoline
Gasoline
Gasoline
Tank Capacity
12000
12000
12000
10000
10000
6000
Spill Protection
No
No
No
No
No
No
Overfill Protection
Yes
Yes
Yes
Yes
Yes
Yes
Corrosion Protection
Yes
Yes
Yes
Yes
Yes
Yes
Any metal flex connectors connected to fiberglass reinforced plastic (FRP) piping at the submersible pump or dispenser must be
cathodically protected or taken out ofcontact with the soil.
USTs filled by transfers of less than 25 gallons at a time (usually used oil tanks) are not required to meet the spill and overfill
prevention requirements as part of the upgrade requirement.
If you have questions about which requirements you still need to meet, or would like to have someone visit your site to help assess
your needs, please call Alan Jones at (801) 536-41 15.
\ _---
Phone Number- - '- -' W Nl 'L\ol
Zip Code
Area Code
Person At e#
Number of tanks at
StateCity
I
Address
t-ocitionT
Owner Name -f
Tank 1 Tank 2
Code
Yes Year:
City
:or@ V flr&,
Facility Name
Street Address
Certificate of Compliance on
( Current yeartag isdisplayed U14!*rffi Yes^ No Yes No Yes No Yes No
Tank presently in use I 0 €"s.tLtr YES NO Yes No YeS -rr}
lf not in use, date lasl used
lf nol in use, depth ol producl in tank (in inches)
Month and year tank installed tqxs-+n8b--)
Capacity ot tank (in gallons)lrU(
-
_>[oK toK toK
Substance stored
Material ot construction of tank (steel, FRP, etc.)5t4a __>
Material of construction of piping (steel, FRP, etc.)FRF ->
Generator lank detection deferred)
suction etc.)
[eekllst
I nventory Control/Tank Tightness Testing
Automatic Tank Gauging
Manual Tank Gauging
Vapor Monitoring
Groundwater Monitoring
lnterstitial Monitoring
Statistical lnventory Reconciliation (SlR)J->
I
i.'
Other method (indicate name ol
Automalic Line Leak Detector
Line Tightness Testing +
Vapor Monitoring
Groundwater
lnterstitial
Statistical lnventory Reconciliation (SlR)
method (indicate name of
(pint n6re)
I inspected
Present
Other
onceftifyVru,o/ - W o,lktr
lnspeclor's
of Owner or Owner's
.\
Nt
0o
Distribulion: White-DERR,Revised O8YOA/9T
UTAH UST PROGRAM
Release Detection ln$pection Checklist
Facility lD No.ifloMs4
-_
I, Ownership of Tank(s)ll. Location of Tank(s) lefl4
d trn n0o
count,
t )+ilx--
tll. fatk lnformation complete for each tank. It facillty has more than 4 tanks, comptete lnformatlon lor aYtionat tanks on separats form.
,ra "w2-1 f rinr4 r^
DA ot i )A.A I
lV, Releaee Detection ForTtnks. tnlicate 'or sach methqd usr d.
V. Release Detection For checkllst andaplp..ropriale iank checkllst(s) for each methorComplCte
Vl-->
Monitoring
\
Tank 1 Tank 2 1 Tar tk? I 5-Ta tkl k
Ycs tr16
The UST system is filled by transfers of 25 gallons or less. lf yes, spill
and overfill prevention is not required.Yes e>
ls there a spill containment bucket or another device that will prevent
release of product into the environment?Yes ffrlt-,^ \-/Ilr _T\I(T Yes
_\Jrd
No Yesls there an overfill prevention device installed on the tank? lf yes,
indicate the type of device: Ball float (in vent line), Automatic shutoff (in
fill pipe), Alarm, or Other (specify)
q9 rrr,o
b,ifu,$4{vU@
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 ?",No Yes No Yes No
For overlill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
Tank 1
Yes No
.:::=:.:::i-
Tank 2
Yes No Yes
I
Tal
No Yes
-.i
I
Td
M
nk4
Tank TankTank rar1-.-r>Nf--
-Piping Piping Piping
lndicate the type of corrosion protection: Non-metallic (NM), Composite
steel (CS), lnternal lining (lL), lmpressed Current (lC), Sacrificial Anode
(SA), or Not protected (NP).r",* Nry\ _+
Sub-Pump SuUPump SL6-PumtSuEPumNP-+
Dispenser Dispenser
lndicate the type of conosion protection on Flex connectors and/or Swing
joints: Booted (B), Total containment (TC), Not in contact with soil or
water (NC), Cathodically protected (CP), Non-metallic (NM) and Not
Protected (NP):trc -
Disp€nser OispQm6r NF--+
Yes rd No Yes r"nk No Yes r*k No Yes Tank NO
Yes P'Pins No ,ipng NO
lf the UST is not protected, was the tanupiping installed before May 7,
1985? lf yes, corrosion protection is not required until Dec. 22,
1998; do not complete the remainder of this section.Y"a ,n@)PlFns\Nlo
Yes No Yes No Yer
The results of the last two cathodic protection tests are available (within
6 months of installation and every 3 years thereafter).Yes -So
volts volts volts volts
volts volts volts volts
Results of the most recent cathodic protection test.
Tank
Piping
Flex
Name of
Test F)ata'
volts volts volts volts
For impressed current system: The results of the last three equipment
operation checks are available. (Equip. check required every 60 days.)Yes No Yes No YeS No Yes No
lnspecto/s
(pdnt nffi6)
Com
tank(s)
4
understand that the following marked items must be completed by
Spill prevention for tank(s)#d.-l--eDecember 22, 1998 in order to meet the 1998 upgrade requirements:
tr Overfill prevention for
re oJ Owner or Owner's
u Facility meets 1998 upgrade requirements
for tank(s)
lf the tank has been retrofit (lined or cathodically protected), indicate the
date the retrofit was
{ Corrosion protection for
Distribution: White-DERR, Yellow-lnspector Bevised 5/98
A.
Overfi
UTAH UST PNOGRAM
and Corrosion Protection
Facility lO N"
Checklist
Ploase complete all in{ormation lor each tank. Use additional forms as neceesary il the facllity'has mor€ tttan 4 tanks,
lk3
@)
UPGHADE
$
Set 1 T..* I Tnt 2 3 TJ*4
Automatic Flow Rgstrictor (it y6r, indicrt€ modol io commgnl3 soction)\l "ryr"t-P
Automatic Shul-off D6vic6 lif y6s, indicato mod.l in commonts ssctionl )
Continuous Allrm Syst.m (if y6r, indical6 modol in commcnb ssction)
Rocords ot last Lino Lork D6t6ctor p€rfo,manco tgat aro avoihblo on-!it.Yo6 -+
'a.tc ol ls6t Lin6 L6ak Dotocto, pgrrormlnco toat 4[ztlq*
\R6suh of lasl Lino Lolk Drtocto, po.to.mlnco tsst ra66 r.+'
Sot 2
(Rrcords of last Line Tiohtnsss T6st ar6 avsil.blo on-6ite 65 No Y6s #
D.t6 of l.st Lino Tightn.sa T66t
RgEult of la6t Lin6 Tightnosa T6st Fail P!.. Flil P6s!Fail Pa6s *
EnVof conifi6d t6st6r:ut.h Tost6.r ration Numbgr: UT 02l
vapor Monitoring (if y6s, u56 V.po. Monitoring chelklirtl
Gioundwalff Monito.ing (if yos, u6o Groundwator Monitorino checklist)I
I
lnterstitial Monitoring (if y6s, u6o lntorstitial Monitoring checklistl
St6ti8tical lnv.ntory Roconciliation ISIRI lif y6s, uso SIR chockli6r)
Othor approvod mothod (it yos, us6 othor method checklist)
Records ot last Lin€ Tightnos6 T6st ar6 availabls on-sits Yos
lFr.'.:-r:-.i#!!!,
No
:TTlliFrilr!
:!:ii:ii:l!;ii:iiiiiririllii:ii:ii
Yes No M iirE Nb[b
D.te of last Line Tightnoaa T66t
Rosuh ot last Lin6 Tightnos8 Tssl Pass Fail Pass Fail Pa E Fail Pasa Fail
Vapo. Moniloring (if yos, us6 Vapor Monitoring checklist,
Groundwat$ Monitoring lif ye6, uso Groundwator Mo niioring chockliEt)
lntotstitial Monito,ing lilvos, u6s lntorstitial Monitoring checklistl
Stati6ticrl lnvontory R.conciliation ISIRI (if yos, use SIR checklist)
i:a:i:j:r:r:l:i:r:l:::l:JJ:t:r:i:r:::::::t::::
tiiril;::ii:ii:iilii
Y68 No
::t::t:::: :l:i:r:::,t :. :: .:l:::;:ii :ii :iiii;ijiidi:J
Yos No Y
Oth6r spprovod mothod (if , uE. bther mothod chgcklist)
Oporeto6 at less than atmospho.ic prossure M:!v Nlt
Slope of piping will allow ALL product to drain into tank wh6n suction i6
t6l6r66d
Y6s No
I
No V lb
Has only Ol{E chock valvo. locatod directly und6r pump Ye8 No Yos No Nb M Nb
All above informaiion on suction piping i6 VERIFI,ABLE, u6o comments
s6ction below lo documont how it is veritiable.
Yos No os No No
I
-rIrE IIIIITIITI
rtllag IIII
-
ZIEilE*I r
-
rI
r
--
--rIrIIIII rr
IIII ffiEEGrIIEI
I IIIIIIIITIIIIIIITI
Ij ffiffiEGE EEE],GE E
Comm€nts
lnsp€ctor's signature:
Signaturo ol Ownor ol Owner'6 Repr8sentativo Pr6sont During lnspection
Disiriburion: WNt6-0EBR, Yellow-l
Dat6:6 f
t
t*th#B ffifrslisi.*ffi
Tt
Y6s No
\
n+
c
SIR as a method of leak detection refers only to monthly monitoring using SlR. An annual test performed using SIR is consldered a tank
tightness test and should be reported on the tank testing and inventory control torm.
\,LsfMAN)Name and address of SIR vendor:
No(a Yes No Yes No Yes frlnventory records lor product lnputs, wlthdrawals, and the amount still
remaining in the tank are avallable for each operating day.
Records include correct # of monthly water monitoring readings..Yes No YEs NO
Yes No Yes NoTank inventory is measured and recorded belore and after each fue!
delivery.
tf.A no Yes No
Yes No Yes NoAppropriate calibration chart is used for converting product level
measurement to gallons and ls available for review.
Yes No
Yes No YesYerNoDispenser pump hao a curtent callbration sticker or appropraate calibration
documentation.
No INo>,
The drop tube ln the rlll plpe extends to wlthin one loot of tank bottom.-+t+
SIR monitoring recorda are avallable for the past 12 months. lf no, indicate
which months are missing in the comments section below.Yes No
k Yes No Yeq No Yes No
Are any months results reported as .fail"? lf yes, specify which months in
comments section below.
Y"" i9 Yes €r'2r"tlat
I
I
b @ ,6)"tllt @
Yes NorAre any months results reported as "inconclusive"? ll yes, specify which
months in comments section below.
Documentation of perlormance claims lor the SIR method is available and shows the ability to detect leaks of
0.2 gph wlth a 95% or greater probability of detection and a 5% or less probability ol false alarm (3rd party
certiiication).
Yes No
c7
Yes No
Yes No
3rd party certification indlcateg the method has been approved for both tanks and lines.Yes No
The volume of product in the tank is measured using a:6us"stick ATGI
lf a gauge stick is used, lt ls long enough to roach the bottom of the tank.T')No
ll a gauge stick is used, the bottom ot the gauge stick is:Acceptable
lf a gauge stick is used, it ls marked legibly and the product level can be determined to the nearest 1/8 of an
inch over the full range of the tank's internal height .
tr€b - Mor-qt
No
q +A
-a ?
Dater
t Complete to appropriate sectiong of the ATG checklist.
egn 1 ,'^
Signature ol Owner or Owner's Representative Present During lnspectlon
lnspector'S
A arr<
Dlstributlon: White,DEBR,
pngc
,rmlffi:iiB m
ffii for,ffirbnk .,rr ,ule railkr.ffi rc,ormr:
.L t.
No
TOSCO MARKETING COMPANY
3550 N CENTRAL AVE 4TH FLOOR
PHOENIX AZ 85012
March 11, 1998
Re: December 22,1998 upgrade deadline for Underground Storage Tanks
Division of Environmental Response and Remediation (DERR) records show you have one or more underground storage tanks
(USTs) which have not met the December 22, 1998 UST upgrade requirements. These tanks are located at CIRCLE K#1844,
506 E STATE, American Fork, facility ID# 1000054.
Under Federal regulations issued in 1988, UST owners and operators have until December 22, 1998 to upgrade, replace, or
permanently close USTs that do not meet the requirements for protection against spills, overfills, and corrosion.
This deadline will not be extended. If your tanks are not in compliance by the deadline, they will not be able to receive
deliveries of fuel.
The DERR encourages owners and operators to meet the 1998 upgrade requirements as soon as possible before the December 22,
1998 deadline. It can take several months to upgrade, close or replace an UST system. Delays are not unusual, and contractors
may not be available if you wait. Start planning now!
Our information shows these requirements have not yet been met:
Tank ID
I
2
J
4
5
6
Substance
Gasoline
Gasoline
Gasoline
Gasoline
Gasoline
Gasoline
Tank Capacity
12000
12000
12000
10000
10000
6000
Spill Protection
No
No
No
No
No
No
Overfill Protection
Yes
Yes
Yes
Yes
Yes
Yes
Corrosion Protection
Yes
Yes
Yes
Yes
Yes
Yes
Any metal flex connectors connected to fiberglass reinforced plastic (FRP) piping at the submersible pump or dispenser must be
cathodically protected or taken out of contact with the soil.
USTs filled by transfers of less than 25 gallons at a time (usually used oil tanks) are not required to meet the spill and overfill
prevention requirements as part of the upgrade requirement.
If you have questions about which requirements you still need to meet, or would like to have someone visit your site to help assess
your needs, please call Alan Jones at [phone].
1
TCDSCCD
M a rketi ngc o m p a ut*rrylo,lgg8
Mn Bill Moore
State of Utah DEQ
DERR
168 Norltr 1950 West
Saltlake City, Utah 841.tgl8rlo
UST Compliance
Circle K Store #TW,Facility ID #1UmS4
sffi E. State St, American Fork
DearMn Moore:
The following items are being sent to comply with your demand letter of December 1 8,1g72
oAn uPdated UST notification fom signed by the cathodic pmtection system
installen
oa coPY of Tanknology's poet-installation repott which statee "The lectifier and
aesociated groundbed were installed to provide cathodic protection to the
under8round etonge tank facility at this location.....The UST facility consiatE of one
6,fiX}'gallon and two 10,000 gallon Sti-P3 tanks, and three l2,W gallon steel tanks....
and associated piping."
You mention in your letter that SIR recorrds were not sent to your office after cathodic
prctection was installed (Marth 19D61. My recorde show that SIR reports for April May, and
lu;ne 1997 for the subiect facility were sent to Me. ]anet Keller at your agency on August 7,
1997. Enclosed are SIR reports for more recent monthe - October, Novembe+ and December.
Spill containment equipment ie scheduled to be installed before December22,1998. An
updated noHfication fonn will be submitted as eoon as I r,eceive verification that the project
is complete.
It is anticipated that this infonnation will aatisfy your agency's requests and you will not
commence the revocation Pfircess of this facility's Certificate of Compliance. pleaee contact
me if you have any questions.
Reepecffully,
,A
RE:
@AJ*^
Ruth Bulmer
Region Compliance Specialist
cc:Myrcn Smith
Don Esperson
DEO /
RECE
RR
l)I
3550 N. Central Ave
Phoenix, AZ 85OL2
B@@4.', -'! xnlo DELIvERED
iFE | $ lv::
.j
,^
STATTSTIGAL INVENTORY RECONCILATION (SlR)
MONTHLY REPORT
Phone [phone]Enviroquest Southwest
Date of SIR report 1113198SIRAS - version 2.8.3
What is the required number of usable inventory days per tank? 3012197
Circle K No. 07844
AMERICAN FORKAddress 506 E STATE
State UT Zip 84003Phone [phone]
Name Circle K Stores lnc.
Addres P.O. Box 52084
Phone [phone]City Phoenix
Phone [phone]Name Circle K Stores lnc.
December 97 1197 1097
Leak
Threshold
Minimum
Detectable
Leak Rale
Calculated
Leak Rate Pass, Fail,
lnconclusive
Pass, Fail,
lnoonclusive
Pass, Fail,
lnconclusive
sph 9ph sph
1000054 1 UnLeaded Plus 12032 0.10 0.2 -0.01 PASS Pass Fail
1000054 2 Unleaded Premium 12032 0.10 0.2 -0.01 PASS Pass Pass
10000s4 3 UnLeaded Regular 12032 0.10 0.2 -0.05 PASS Pass Pass
1000054 4 Unleaded Premium 6016 0.10 0.2 -0.01 PASS Pass Pass
1000054 5 Unleaded Regular 10152 0.10 0.2 -0.05 PASS Pass Pass
1000054 6 UnLeaded Plus 10152 0.10 0.2 -0.01 PASS Pass Fail
Administrator: MichaelLessley
tr"r-rI-tl
ffi ###'EiffiHiiffi'iffi#*E###tfiitrffi
illffi s,ffi.._--*._Tffi.s,#,,,,
[#"fl#+F,,ffi,ffi.'*
E$lfi[i]tr].*ffii.bi,
*ffiffi],##,,
i#Hrr*1fiffi&.Htfs.ff
ffiffiiffih.ffi
ffi
:iiLiiiii:iii,iii.:=iIilEfi iNiIti€AlG il'I,aEfil
ifistiisstl ffi.:S.S,ffiffi ffi#$&.Eilffi
A
Enviroquest Southwest Phone [phone]
SIRAS - version 2.8.3 Date of SIR report 1219197
t9711 What is the required number of usable inventory days per tank? 30
ffiffiffi
Circle K No. 07844
Address 506 E STATE City AMERICAN FORK
Phone [phone] State UT 84003
Name Circle K Stores lnc.
Addres P.O. Box 520E4
Gity Phoenix Phone [phone]
Name Circle K Stores lnc.Phone [phone]
November 97 1 097 9t97
Leak
Threshold
Minimum
Detectable
Leak Rale
Calculated
Leak Rale Pass, Fail,
lnconclusive
Pass, Fail,
lnconclusive
Pass, Fail,
lnconclusive
gph sph gph
1000054 1 UnLeaded Plus 12032 0.10 0.216 0.0124 Pass Fail Pass
1000054 2 Unleaded Premium 12032 0.10 0.216 0.0333 Pass Pass Pass
1000054 3 UnLeaded Regular 12032 0.10 0.2'16 -0.037 Pass Pass Fail1000054 4 Unleaded Premium 6016 0.10 0.216 0.0333 Pass Pass Pass1000054 5 Unleaded Regular 10152 0.10 0.216 -0.037 Pass Pass Fail1000054 6 UnLeaded Plus 10152 0.10 0.216 0.0124 Pass Fail Pass
Administrator: MichaetLessley
th"rd-h
STATTSTTCAL INVENTORY RECONCTLATTON (SrR)
MONTHLY REPORT
tr#ffiffi*rffi*#.dffi"iffiI
ffi
r.ff#HmlliffiffiffiHhH
l1T'*fiEii$ f
Lrffiffi,ffiffiffi
flffiffiffi.ffiffififfi ffi"tf;*r,*lfilh-t lililffiIt
,\
STATISTTCAL INVENTORY RECONGTLATION (SrR)
MONTHLY REPORT
Enviroquest Southwest Phone [phone]
SIRAS - version 2.E.3 Date of SIR report 1119197
10t97 What is the required number of usable inventory dap per tank? 30
ffiffiffi
Circle K No. 07844
Address 506 E STATE Gity AMERICAN FORK
Phone [phone] rstate UT Zap 84003
Name Circle K Stores lnc.
Addres P.O. Box 52084
Caty Phoenix Phone [phone]
Name Circle K Stores lnc.Phone [phone]
October 97 9t97 8t97
Leak
Threshold
Minimum
Deteclable
Leak Rale
Calculated
Leak Rate Pass, Fail,
lnconclusive
Pass, Fail,
lnconclusive
Pass, Fail,
lnconclusive
9ph gph sph
1000054 1 UnLeaded Plus 12032 0.10 0.153 -0.175 Fail Pass PASS
1000054 2 Unleaded Premium 12032 0.10 0.153 -0.016 Pass Pass PASS
1000054 3 UnLeaded Regular 12032 0.10 0.153 -0.047 Pass Fail PASS
1000054 4 Unleaded Premium 6016 0.10 0.153 -0.016 Pass Pass PASS
1000054 5 UnLeaded Regular 10152 0.10 0.153 -0.o47 Pass Fail PASS
UnLeaded Plus 10152 0.10 0.153 -0.175 Fail Pass PASS
Administrator: Michael Lesstey
th"rdI-h
I
a
tffi
ffiHfffiffi,ffiiffi
ffitriffiffifrffiiffi
frffiiliiffi$trIi#
,ffi#ilffiiffi.Ttrtrffi
ffiffi1i,ffi$iilffiiiffi $\lfl*frS
Hfl#l*t*Iiirffi
E[,ffiIi
ig,*ffi*ifti
1000054 6
POST INSTALLATION SURVEY
The Circle K Corporation
Store #7844
506 E. State
American Fork, UT 84003
I. SUMMARY
A f inal structure-to-soil potential survey was conducted on
O3-26-96, on the cathodic protection system for The Circle K Corporation
at Store #7844, 5OO E. State, American Fork, UT. The rectifier and
associated groundbed were installed to provide cathodic protection to the
underground storage tank facility at this location. The results of the
survey indicate that all of the structure-to-soil potential measurements
satisfy one or more of the criteria for cathodic protection as established
by the National Association of Corrosion Engineers (NACE).
It is recommended that the output of the rectifier be recorded
monthly and a potential survey be conducted as required by Federal and
State regulations (see Section Vl.).
II. INTRODUCTION
On O3-26-96 Tanknology's Corrosion Protection Division installed
the cathodic protection system as designed and engineered by a certified
NACE Corrosion Specialist.
The UST f acility consists of one 6,O0O-gallon and two
10,000-gallon Sti-P3 tanks, and three 1 2,000-gallon steel tanks located
in two tank beds. CP for steel tanks only and associated piping. The
cathodic protection system for the underground tanks consists of eight
EZ-SS-64 anodes energized by one 80 volt-O8 amp SENTINEL rectifier.
III. TEST PROCEDURES
ln order to determine the effectiveness of the cathodic protection
system, structure-to-soil potential measurements were performed at
1
(
I
t
LOGK'"
POST INSTALLATION SURVEY REPORT
Corrosion Gontrol I Cathodic Protection
UST SYSTEM
FOR:The Gircle K Gorporation
906 East Anderson Lane
Austin, TX 78752
ATTN: Mr. Ken Younger
SITE:Store #7844
506 E. State
American Fork, UT 84003
BY: Tanknology Corporation lnternational
Robert . Hall, P.E.
Corrosion Engineering Manager
(NACE Corrosion Specialist # 132011
RE frr-nn nffiffi
APR t fi 1996
r-n vi r<,cilt"'itui u ti riX't* u n t
April 'a1, 1996
TCI Job #O828O
rAN K NOL OG y CO R pO[] A I I L) N I t,t I [ ::t t'] t. r i i.) r.1,",
5225 Hollister St. . Housron, Texas 77040_6294 c (7131 690-8265 . 1 (800) 88g_8563 . Fax: (713) 690_2255
1 E()hNOLOGY FOB TANKS
AND THEIR ENVIRONMENT
'rH$.
t
:il:, '1t,..:rr,,tt. ,i: .: ,-\,.j ,:::... lr I ,;r,r,.,r, .r,,j1
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
168 North 1950 West
P.O. Box 144840
salt Lake city, utah ull4484o
[phone] Voice
[phone] Fax
(80r) 5364414 T.D.D.
Michael O. Leavitt
Govemot
Dianne R. Nielson, Ph.D.
Executive Direcor
Kent P. Gray
Dircctor
TO:Ruth Bulmer
Tosco Marketing Company
dba Circle K Stores Inc.
3550 North Central Avenue, 5th Floor
Phoenix, Arizona 85012
DATE: l2ll8l97
FROM: William Moore
RB: NON-COMPLIANCE OF UNDERGROIIND STORAGE TAI\KS AT CIRCLE K # 7844,5068.
STATE ST., AMERICAN FORK, UTAH; FACILITY ID# 1000054.
To continue to maintain a valid Certificate of Compliance, the facility must be in compliance with Federal and
State Rules and Regulations. A review of our records has shown that the following information is lacking:
DERR received a copy of your final "MTCF' upgrade report on December 18, 1997. This report is still
lacking aNotification form signed by the Utah Cenified Installer who installed the impressed current system
and documentation of a permanent form of release detection. Since according to the MTCF report information
this was Tanknology who may have been overseen by Westech, who took out the install permit, the
notification should be signed by either the Westech Utah Certified Installer, or the Tanknology Utatr Certified
Installgt, if they have one that was on site.
tll Submit a properly completed form Notilication Form (EPA 7530-L), certifying to DERR the
proper installation of the Impressed Current system and if that system was properly bonded
to the steel piping. Ah, if Spill Control was installed have that Utah Certified Installer certify
that proper installation separately.
121 In addition, you must also document you are using a 6spermanenf'form of Release Detection
on the site. Corrpro indicated you were using SIRAS, but did not provide a copy of the monthly
reports after installation of the Impressed Current.
The above information must be submitted to this office by Al8l98.If it is not received by the date specified,
we will commence the revocation process of your Certificate of Compliance. Continued non-compliance will
result in the fees on your Certified USTs to be increased from $75 per tank to $150 per tank and failure to pay
the additional fee can result in lapsing of your UST Certificate of Compliance. If you have questions
concerning this matter or need any assistance, please contact William Moore at [phone].
Sn+re /D # /@5/
^ru
Cathodlc Protectlon Servlces
a Corrpro Company
Corrpro
Companies,
Inc.
ASTM ES 4G94 UST UPGRADE
COMPLETION REPORT
The following is a summary of the results of ASTM
existing Underground Storage Tanks, in accordance
ES 40-94 testing used for the upgrade of
with state of Utatr.ulirg on ES 40 proceduresas provided by Corrpro Companies, Inc.
UST Owner:Circle K Corporation
4343 East Camelback, Ste. 201
Phoenix, AZ 85018
Site Name:Circle K Corporation
Circle K Store #7844
506 East State Street
American For( UT 84003
Approved Method: MTCF@ Mean Time to corrosion Failure
Date of Site Assessment:
Date of Tightness Test:
Date CP Sytem energized:
Date of post-activation potentials:
The following permits were obtained in
commencing with the UST upgrade(s):
Jaly 25,1997
Jaly,1997
March 26,1996
September 9,1997
Section I Permits
accordance with Utah state regulations prior to
Date of fssue:
Company Installation permit
Company Permit #: //
T ank Installation permit
Local Permi(s) & #:
Date of notification of DERR for Site
Date of notification of DERR for Cp UCorrpro submitted the required arnended UST notification
1997
1996
signed by the Certified Installer who performed the work.
1997 The form is
(r
Section 2 Corrosion Exnert Certification
All phases of work were conducted under the responsible supervision of a qualified corrosion
expert. The corrosion expert certified to the UST owner that all personnel performing the
assessment were qualified to do so.
Corrpro's corrosion expert did certify to the UST owner that all work was performed in strict
accordance with Corrpro protocol, the ASTM ES 40-94, and the Utah state approval.
Corrpro notified the OiO of the requirement for a permanent form of release detection (not
including lnventory Contol with tightness testing) and the owner has implemented the
SIR method. A copy is attached on Appendix D. N/A
Section 3 Safefv & Resulation
All Corrpro personnel and their subordina.tes have complied with all applicable federal, state, and
local health, safety codes and regulations.
Section 4 Pre-Site Assessment
Prior to upgrading, the UST's were tested for tightness in accordance with Utah regulations, at the
.l / gallon per hour rate. Testing was conducted by a Utah state certified Tester.
The UST information was not obtained by a certified corrosion tester working under the direction
of a certified corrosion expert. If site work not done by a certified corrosion tester, person was
Corrpro certified by the Corrpro C_orrosion Expert, to conduct MTCF Site Assessment.
Corrosion Experf -
-Kobt..I
Lv.ri:,. NACE #: 3513
CorrosionTester: t ztlie /l/c/lc^.s{ri"-" NACE#z /*-z
-The site specific information includes, but is not limited to; name, address, phone number of
location; nalne, address, phone number of owner/operator(s), number and capacity of tanks
tested, the location and dimensions of ttre UST's, age and material construction, product(s) stored
in each, type of fill mound tanks, leak and repair histories, where available, and site plans and
installation spec's. where available. Where site plans/ spec's. are not available, Corrpro personnel
have made a site sketch. All information is presented on Appendix I, MTCF Report data.
Information was obtained from the surrounding are4 such as foreign structures, utilities, existing
waterways, lakes, sfreams, etc. See Appendix A, MTCF Report Data.
Section 5 Site Assessment
All testing was conducted under the responsible supervision of Corrpro's corrosion expert.
Sfray currenl interference corrosion was tested for during the site assessment. See Appendix I for
results.
Tank backfill resistivity was measured using a Nilson model400 soil resistance meter coupled to a
single calibrated resistance rod. Resistivity measurements were conducted in each soil bore, at two
foot increments to the bottom of each bore. See Appendix A for results.
Structure-to-soil potentials were measured with reference to a copper-coppsr sulfate electrode
coupled to a digital volt meter. See Appendix A for results.
The presence of corrosion directly below the filIriser was tested using a mechanical probe. The
probe was equipped with a measuring device capable of detecting pits to a minimum resolution of
1/16 inch.
Pitting was not detected.
The extent of pitting was: <,060"
Two (2) Borehole tests were conducted in the tank backfill material.
Soil samples were sent to Warren Rogers Associates in Providence, Rhode Islan4 where they
were tested in accordance with ASTM ES 40-94 and indusflry standards.
The results of all test methods used me included in the MTCF report.
Soil pH was measured.
Soil moisture content was measured in the backfill.
Electrical continuity tests were conducted.
Chloride ion concenfration, sulfide ion concenfration, and sulfate ion concentration were tested for
at the lab.
All pertinent data is presented for review on Appendix A, MTCF Report Data.
Section 5 Site Assessment cont...
Hydrocmbon concentratiorL REDOX potential, current requirement, coating resistance, coating
efficiency, and wall thickness tests were not required using the MTCF method. The results of any
of these tests, if accomplished, are presented on A,ppmdix{V. Not Included
One soil sample of every ten is subjected to an independent QC analysis. If not passing, all
samples collected since last successful QC are re-analyzed. The results of such testing, if
accomplished, is presented on Appemdi*lA Not Included
Field testing was conducted by Nic Wellenstein, who is certified by Corrpro Companies, Inc.'s
corrosion expert as competent to conduct MTCF field data collection.
No suspected corrosion activity was noted on the UST's.
Al[ structural and elecffochemical characteristics measured or observed in field or lab testing
results g compatible with the effective use of corrosion protection. These tanks PASS the
ASTM ES 40-94 analysis.
Any significant evidence of corrosion activity was documented by the corrosion expert. N/A
(r
I
Section 6 Model Analvsis
The statistical analysis model was based on a sufficient sized database with various factors that are
accounted for statistically to reach a confidence level of .99.
The procedure is based on an evaluation of all data gathered insitu.
The mathematical formulation of the procedure conforrns to accepted physical and
electrochemical characteristics of the tank corrosion process, with independent validation.
Parameter estimates are based on a minimum of 100 sites where a minimum of 200 tanks were
excavated and evaluated by a qualified corrosion expert.
The current database contains not less than 50 sites where the Site Assessment was performed and
a Mean Time to Corrosion Failure was calculate4 that are within the geographical region of Utatr
and surrounding Intermountain States. Additional sites are added to the database regularly, to
continuously upgrade the predictive model.
This procedure meets the standards of statistical and elecftochemical admissibility.
The database contains representative samples of both leaking and non-leaking UST's.
This model is specific as to soil type and incorporates the depth of ground water and rainfall in the
immediate geographic area of the testing.
The standard deviation of predicted mean time to corrosion failure is less than or equal to 1.5
years.
This model generates a probability of corrosion failure based upon a comparison of actual tank
age versus expected leak-free life. See Appendix A, MTCF Data
The conclusions are based upon the expected leak-free life of a tank at the specific site, as
determined by the data analysis.
The report provides the expected leak-free life and present and funre probabilities of corrosion
failure for all tanks investigated.
The report includes a listing of tanks whose age is less than the expected leak-free life, where the
probability of corrosion perforation is N/A than .05.
The tank is currently leak-free. The ability to detect is _> 957o_. Thresholds of the tightness
test used are-._-_-_-----__-_ l_.
Hydrocarbon tests were not conducte{ as they were not necessary.
The tank age is lesslleg the expected leak-free Iife of the tanks.
The present probability of corrosion perforation N/A less than .05. See Appendix A, Page L
Section 7 Experts Determination
The analysis was reviewed and the final upgrade determination made by the corrosion expert on
each tank tested for upgrading.
The corosion expert submitted a copy of the report to the owner/operator after reviewing the
analysis, which includes a determination of the upgrading zuitability made for each UST that is
signed by the corrosion expert who is listed with DERR as allowed to sign for Corrpro.
Signed
tr
R. C. Lunder
Date
-7|q'.l
APPENDIX A
Corrpro ASTM ES 40-94
Report
CORROSION EVALUATION OF
UNDERGROUND STORAGE TANKS
CIRCLE K STORE NO. 7E44
506 EAST STATE STREET
AMERICAN FORK, UTAII
(THREE 10,000 GALLON GASOLINE TANKS)
"A Cotnmittnent to Excellence"
610 Braodywioe Parkway
'W'est Chester, PA 19380
T el 610 / 3 4tr7002, Fa.x 6t0 / 34+7 092
Corrpro
Companies
Incorporated
SEPTEMBER 5, 1997
On July Z5.e lgg7, Corrpro Companies, Inc. performed an engineering analysis on underground
storage tanks at the above referenced location. There were three (3) 10,000 gallon gasolhe
storage tanks evaluated.
All testing and analysis was performed in accordance with ASTM Standard ES 40-94 "Alternative
procedures for the Assessment of Buried Steel Tanks Prior to the Addition of Cathodic
Protection" as outlined in EPA OUST Interim Guidance Memo on Integrity Assessment of Bare
Steel Tanks dated October 21,1996.
Based on the results of the corrosion evaluation recently completed on the underground
tanks, these tanks satisff the requirements of ASTM Standard ES 40-94 and are acceptable
for upgrading with cathodic protection.
The following plan for upgrading of the tanks with cathodic protection is required-
The p bilitv of failure is less n 0.05.
l) Prior to any upgrade activities, assess the tanks using ASTM Practice E 1430 or a
method that has been certilied in accordance with Federal EPA requirements to
establish that the tanks are not leaking.
2) Install cathodic protection to provide corrosion protection to the exterior surfaces of
the tanks and associated steel piping.
3) Implement an approved monthly monitoring leak detection system.
4) Assess the tanks again, approximately six (6) months after the cathodic protection
system has been in operation, using ASTM Practice E 1430 or a method that has
been certified in accordance with Federal EPA requirements to insure the continued
leak free condition of the tanks.
5) Submit the corrosion evaluation report, evidence that the tanks have been properly
tested and are leak free and cathodic protection system test data to the regulatory
authorities as evidence that the tanks have been satisfactorily upgraded with
cathodic protection.
Anchorags
Atanta
Bahrain
Billings
Eoston
Chanote
Caigary
Cleveland
Detroit
Dhahran
Edrmnton
Geneva
Hong Kong
Houston
Jakarta
Ldayeno
Lisbon
Loodon
Los Angeles
Malaysia
Mihxauke€
Minneapolis
Nafl Orleans
ocean Gty
Philddphia
Phoenix
Regina
Sar Frarcisco
Sm 0iego
S€atte
Shaldt
Sing+om
Shckton 0n Tees
VaEouYer
W6hingbn, OCChnago
1
Corrosion evaluation field testing at the wrderground storage tank location consisted of collecting
site information, performing soil borings and recording data reiative to the electrical properties'
Chemical tests wire conducted in the laboratory on the soil collected from the borings. All data
were then anallzed by Corrpro Companies, lnc. and Warren Rogers Associates including the use
of a computei modei to .uLulut. and complete a Mean Time to Corrosion Failure (MICF6)
analysis for the tanks.
Attached is a copy of all the test data obtained and analyzed during the conosioa .ru1*1i6n and
the results of the MTCF analysis.
Since the tanks evaluated are older than 10 years old, in order to meet the regUlatory requirements
for upgrading with cathodic protectiorq the ta::ks must be assessed for corrosion holes by a
metma *nict is approved by the implementing agency. Corrpro Companies Corrosion
Evaluation which is- performed in accordance with ASTM Standard ES 40-94 "Altemative
procedures for the Assessment of Buried Tanks Prior to the Addition of Cathodic Protection" has
been approued by many of the implementing agencies. If using this method, to be acceptable for
,pgud;g wttr cathodic protectior! 1) The probability of corrosion failure must be less than 0.05'
or 2) The probabilify ofpitting corrosion must be less than 0'05'
The following conclusion resulted from MTCF Analysis recently completed on the underground
tanks:
o The probability of corrosion failure, based on the results of the corrosion survey on the
underground tanks, is 0'035.
NOTE:The results derived are entirely dependent on the assumption that the tanks
are leak free at this time. The leak free condition of the tanks should be
verilied by the owner/operator prior to the installation of cathodic
protection.
Since the probability of corrosion faiture is less than 0.05, these tanks satisfy the requirements of
ASTM Standard ES 40-94 and are acceptable for upgrading with cathodic protection.
MTCF@ is a Seryice Mark ofCorrpro Companies, Inc., Registered in the u.S. Patent and Tradenark Afrce
Ctcle K Store No. 7844
American Fork, UT 2 September 5, 1997
WRA M.T.C.F." - Corrosion Failure
Prepared on Septsrnbor 3. 1997 fo,:
TANKNOLOGY-NDE
P.O. BOX 9429
AUSTIN. TX 78766
610 Brandy
inpild by,tcorfiro cokpanles, nb.
wine Parkway, West Chester, PA
Locallon lD: T-NDE-CK-7844
CIRCLE K 7844
506-E STATE
AMERICAN FORK, UT
Op€retor: BUD lvlATTlX
5'r2-451-6334
PRO8ABILITIES AND TANK INFORMATION
Locatlon Name Condltlonal ProbabllllY
ol corroslon Failuro
Glven Plttlng
coaroalon
Probabllity ot
LocalizGd coraoslon
It
Saturatsd
Mean Tlme to
Corroslon Fallurs
lErt.d..l t..t f,.. Ur. I
Tank Age
clRcLE K 7844 0.035 N/A N/A 15.5 11.00
RECOMMENDATION:
Tha condi onal probability of cofroslon Fallur6 civen pitting cor.osion meets ASTM criterla as set lorth in ASTM ES 40-94 for upgrading by cathodic Prolectlon '6lrofit'
Tank #Locatlon Gallons Tank
Type
Product Bottom -Dopth
(hrches)Dlmonslons lnternal
Water
lnternal
Coroslon
lnformallon
Conlirmatlon'
lsolated
(Y'N)
1 WEST 10000 96X324 12t31ia6 Steel REG 11 0.00 I N
2 CENTER 10000 12131186 Steel SNL 1'l 0.00 Smooth 1 N
3 EAST 10000 96X324 12l31i86 Steel PRM 11 0.00 Smoolh 1 N
r-conll.mrllohi l.Srm. st conpany lnlo(ln lbo: 2'D[lGronl lh'n cooP{ty lnlo'mallo'l
Th. r.irl! r! hsv. dcdv.d .r. .nl!.ly dcp.nd.nl on lh'
'!3umPlloo
lhsl lhe ls'rt' ar6 llghl al lhli l!n6'
Englneor:
)
)
tlttt tt ttt
Yoar
lnstalled
Smooth
96X324
=
T
T-NDE-CK-7W
SITE INFORMATION
MTCF Report - Page 2
Active Electrical Planl Nearby? TyPe of Systemi Dislance in feet?N Overspill containment on site?N
Cathodically protecled structures nearby?; Oistance in feet?N Monaloring wells on site?N
Utility vault or conduit nearbY?N Leak history available on sile?N
Polable water well nearby?N Repair history available on site?N
Waterway, slream or lake nearby?N Site plans available on sile?N
Line leak detectors installed?N lnstallation specs available on site?N
Piping material?Type of pump?P
LABORATORY INFORMATION
ON SITE SOIL SAMPLE ANALYSIS
pH
Sulphides
(Ppm)
Chloridss
(ppm)
12.27% - 16.650/o 8.9 - 9.9 304 - 527 0.000 - 0.000 13- 79
cdJd'ilYbd.dn6A,tlA'20,1 surplJd.r h sd.i ro EP 17r r
SAMPLE
LOCATION
(HOLE # )
DEPTH
(FT)
SQUEEZE
ITIIOISTURE
TEST
(YES/No)
GROUND
WATER
LEVEL
(FEET)
TYPE OF
BACXFILL,
SAMPLE
LOCATION
(HOLE # )
OEPT}I
(FT)
SOUEEZE
MOISTURE
TEST
(YES'NO)
GROUND
WATER
LEVEL
(FEET}
TYPE OF
BACKFILT
1 TOP
MIDDLE
BOTTOM
N
N
3 TOP
MIDDLE
BOTTOM
6
11
N
N
1
1
TOP
MIDDLE
BOTTOM
" . tyD. a a.an l-s.di ztrL&. S.q r.cqi a.nrbLi 5rP.. G.e[ 6'Odlr a co.ihldirr
ON SITE HOLE PROFILE
HOLE #4 - POTENTIAL AND
RESISNVIry PROFILE
HOLE #2 . POTENTIAL ANO
RESISTIVITY PROFILE
HOLE #3 . POTENTIAL AND
RESISTIVITY PROFILE
HOLE *1 . POTENTIAL AND
RESISTIVIW PROFILE
DEPTH
(FT)
POTENTIAL
(Nv)
RESISTANCE
(oHM-cM)
DEPTH
(FT}
POTENTIAL
(Nv)
RESISTANCE
(oHM-CM)
RESISTANCE
(oHM-GM)
DEPTH
(FT)
POTENTIAL
(NV}
DEPTH
{FT)
POTENTIAL
(Nv)
2 -802.002-854.00
37800.0025200.OO 4
6
8
1',|
-825.004-848.00
46200.0038220.00 -830 006,850.00
420420.00 -B27.OO 67200 008-845.00
820.00 63000 0011-838.00 126000.00I
I
I llttttttttttttt llI
Moisturo Content
(% Dry weight)
Conductivity
(micromhos))
)
6
11
2 TOP
MIDOLE
BOTTOM
RESISTANCE
(oHM-cM)
260400.0063000.00
-I
------r-----rr
I
I
I
I
-=-
APPENDIX B
Permits f Notrl;col,;ons
/*E DElt -t I P.rltt xodLfl.catloa
PbE I lI5
c.rtM.d IE t lt.ar. on
NaD€€r
Facility ID* (if not a new facility)I oOOo s4
Iat*
Addres
ContsacE per
"\
UST .lstaf f ation/Upgrad.e Permr
Cert. *
Cert. *
P.saLt llor ,l\l- 16Lrr-t57- OSor?
rL (gq3*@Ez
Cert. * TL
t I New hstalLation I X upsrade
ciw k{in -t"t"--DS- ae=@-
6 q-7
Phone * rs(z I 331- F?86
I
flI
I
I
i
I
i
i
I
l
i
i
I
da
E)q).
E:<p.
Eg)
raclllty !*
ci Arr.<>u'tu E-/l-state-.128_oo E,4
Total Installation Tank Fee/permiE
Phone * lk)l I >5 6-'73-t-l
{l .Zoctte
-
:
I
I
t
UDuBuaI or c:.tcauatl,ng cl,rcunrtaacct
Contact
Trrdrr lBvolv.d LD IDttrllatLoa uDgrad.
t L 3 Lt 5 6
Install/--'Capacity (ga11ons)lZlL tzlr.-12v lOk--td<(*.
Illl)e-(nlP, Stee1, etc.)st'z*----t
Substance to be SLored
Piping Tl4:e (Press.,
Suct,ion, craviEy)
irfD. of lDrtellrtlon/gDgradc
Dotcrl.Dtl,oa tfunbir
b
uall cq>lctcd forE tot utah DeparEment of EnvironmenEal euality
Division of Environmental Response and Remediat,ion
168 North 1950 west, 1st Floor
SaIt LakF CiCy, Utah 84116
state use only: Dace Appro""u Lf A)/qa App. By QL Dare permir, Mailed L/7/q6
ck_* b2gb3 tlz4q6
62qra LlTolqb
Date rorh rl11 cmcnc" F< lo lqq 6....-_
address 906 E. C*-t{e-
Tank lf -
T,*.+rc(l C qThoAri- Pr,.r t*e*rb-^.
01/79/96 FRI 08:46 FAX 80r 2F-\d054 IIESTECH FUEL EqUIPUENIh.
,,. f lnstallatlon/Upgrade NottflcaUor,
Facility lO# (lf nol a new racflM [ ] New tnsElladon t X I Upgrad€
Datg work will commence IEBRUARY l99G
C.rtltl€d T.nk ln3trller Name STEVE fOStER Co,L * ILOO43 Exp. datc-fullr97
Compa WESTECH I'UEL EQUI PMENT Phone #( Eol t2 66-2545
Addresc P.0 ' BoX 57307 Clty 9ALl I.AKE- c IrY_ Shte_lTAB 84157-0307
Theulah undsrgound stollgo Tank (usT) rub. (t tah Adn{ntsu8Ir/6_cod. n311.21 3.3) r.qutE that usT l||3tr[r|!
'lofitvthe Execuilv€ secrerary, utah soild ino nazaroius waste cmrror qoeru, 30 o.y. 6iirt1nsrrrn;; ffiffi#;iregulat€d usT sy3lem. T}is torm ha3 b€€n pEparBd to arslst !,ou in provrarng irrr iriormanin. g"bra lruElxng oruPgradlng an usr 8Flcrrt pl€ase compl€te nd torm rnd Dtu; I ro'rtre otv-ision oi Eii'ffiruntat F..Frs6 end. Hemediaion at th. lddr.ss balow. r anli anks or thcs arg ,emo,/rd o, npraoe+ a 6iool;;ffii;r-il*;;;E;I,r:;\\ must bc aubmined and appro'€d. and a iite assassmenr must be parlor?asd at ciosrra, -- '-' '
Tenk Own.r CIRCLE K SToRES INC ,Phon€ # I 51 ) 339-88 35
Address 5 EAST N c AU TIN sleteJl_zplgziz__
Contact Person in charg. o, ta0l6 KEN YOUNGER.
Faclllty Name CI RCLE K #7 844
Addt€ss 5q5 EASI SrArE STREET CitygEBLcAN rOE{_ State UIAH Ap 84003
lnstallatlon/lJpgrado ldorma on
- Tank #
Install/upgrade
_ Capaclty (gallons)
Type (FRP, Sl€el, 6tc.)
Substance to be slored
- Piping T)tre (Press., Sucdon, Gravity)
Tank Lcak Detection m€thod
_ Linc l.rk dctection method
Form ol Conosion Protectlon
Spill device to be instaUed (YN)
- overflll d6vlc€ to be hstalted (y/N)
5
UPGRADE
10.000
STEEL
6
UPGBADE
6.000
STEEL
unuruer or orrlnuaflng clrcunrtfic.r aryoct€d!_ rNstallcATEoDrc pRorEcrroN
Mail compl.t€d torm lo: Utah O.partm€nt ol Envlronm€nlal Ouellty
DivBion ol Erwlronalrntal Respons€ and hemedlatlon
168 l.lorth 1990 WasL ist Floor
Satt Lab Clty, Utah 84116
Slalo Us. Only: Oalo R!cd_ Rrdd gy_ Notts! SJrt To olo 5ra&r la"ai$l
@oo?
3
UPGRADE UPCRADE UPCMDE UPGRA.DE
r2,000 12,000 12,000 ro,0oo
STEEL STEEL STEEL STEEL
Contact oerson------r-.--- Phone # ( 801 ) 756-7377
APPENDIX C
Tightness Testing
fr-,tL, '1 ? ^ t Jf rnlX 4f /R*/a
Triangle Environmental, Inc.
2525lVest Burbank Boulevard, Burbank, Califomia 91505
[phone] FAX [phone]e2e
T.E.I. UST TESTING SYSTEMS SUMMARY SHEET
Precision Underground Storage Tank System Leak Test
Client:
TOSCO MARKETING COMPANY
3550 N. Central Ave., 4th Floor
Phoenix, AZ 85012
Carmen Tucker
(602) 2004530
Circle K #07844
Test Date: 3ll0l97
Facility:
Circle K #07844
506 E STATE
AMERICAN FORK, UT
Work #: SM80093
County: LI'IAH
Cross Street: E. STREET
84003
Tank Test System
Type
Trnk
Rrte/Results
Llne
[Jllage Result Rete/Result [.,/D Result#Product Capacity
I Unleaded Plus 12032
2 Unleaded Premium 12032
3 UnleadedRegular 12032
4 UnleadedPremium 6016
5 Unleaded Regular 10152
6 Unleaded Plus 10152
System 4000
System 4000
System 4000
System 4000
System 4000
System 4000
0.006 PAss
0.031 PASS
0.042 PASS
0.04 PASS
0.013 PASS
0.023 PASS
PASS
PASS
PASS
PASS
PASS
PASS
O.OO2 PASS
0.003 PASS
O.OO2 PASS
0.006 PAss
0.004 PAss
O.OO3 PASS
PASS
PASS
PASS
PASS
PASS
PASS
Certlf,ed By:Technician: Steve Martin
Mfgr's #: TEI427
State Lic. #sz 12284
ID- 9116030 ur 021
Comments:
Compliance test ALL
This precision tank testing system has been third party evaluated according to the guidelines ofthe EPA
procedures for annual leak detection systems and found to exceed the criteria of detecting a leak of 0.10
gph with a Pd>957o and Pfa< 5%o es required by Local, State and Federal EPA UST Technical
Standards Part 280 for precision testing systems
Triangle Environmental, fnc.
T.E.I. SYSTEMS TANK, LINE AND LEAK DE TECTOR TEST REPORT
Facility: Circle K #07844
Test Date: 3ll0l97
lYork #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. ofExpansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. @):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
12032
96
67
8963
74.sYo
0.730
0.000696
0
0
s0.9
1.8
6:00:00 PM
5:00:00 AM
0.006
PASS
Test Method:
Manufacturer:
L/D Model:
L/D Serial #:
Line Drain Back (ml):
L/D Trip Time (sec):
Holding Pressure (psi) :
Metering Pressure (psi):
L/D Test Rate (gph):
L/D Result:
RJ. FTA
Red Jacket
FX-l
091595-7140
100
2
10
9
4.0
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum (psi):
Llllage Result:
I'LLAGE
3069
7:11:00 PM
I
PASS
Test Method:
Pump Brand:
System Type:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TEILT-3
Red Jacket
Pressure
50
l:50:00 AM
2:05:00 AM
45
43
0.002
PASS
)
Tank #: 1
Product: Unleaded Plus
i?#ilffi,ilffifffiiffi$iBffi
iffi
Triangle Environmental, fnc.
T.E.I. SYSIEMS TANK, LINE AND LEAK DETECTOR TEST REPORT
Facility: Circle K #07844
Tank #: 2
Product: Unleaded Premium
Test Date: 3ll0l97
Work #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. ofExpansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. (F):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
12032
96
70
9398
78.LYo
0.730
0.000696
0
0
48.78
1.8
6:00:00 PM
5:00:00 AM
0.031
PASS
Test Method:
Manufacturer:
L/D Model:
L/D Serial #:
Line Drain Back (ml):
LID Trip Time (sec):
Holding Pressure (psi):
Metering Pressure (psi):
L/D Test Rate (gph):
L/D Result:
R.J. FTA
Red Jacket
)(LP
50491-23t4
250
J
l0
l8
4.0
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum (psi):
Ullage Rezult:
T]LLAGE
2634
7:17:00 PM
I
PASS
Test Method:
Pump Brand:
System T1'pe:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TETLT-3
Red Jacket
Pressure
50
3:10:00 AM
3:25:00 AM
167
t64
0.003
PASS
3
.ff*I'fi8.l$G#S*iY*ffi9ffi ffiffiffirS.Elqm #,ftSl$ffi.#
iffi
I$ :iilr#S,$.1ffis.I##
ffifiXil*SliriiFi$
Triangle Environmental, fnc.
T.E.I. SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT
Facility: Circle K #07844
Tank #: 3
Product: Unleaded Regular
Test Date: 3ll0l97
Work #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. ofExpansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. (F):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
12032
96
75
10083
83.8%
0.730
0.000700
0
0
49.87
2.0
6:00:00 PM
5:00:00 AM
0.042
PASS
Test Method:
Manufacturer:
L/D Model:
LID Serial #:
Line Drain Back (ml):
L/D Trip Time (sec):
Holding Pressure (psi) :
Metering Pressure (psi) :
L/D TestRate (gph):
LID Result:
R.J. FTA
\A4I
VPR
47615
ls0
2
t7
18
4.0
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum @si):
Ullage Result:
TJLLAGE
1949
7:24:00 PM
I
PASS
Test Method:
Pump Brand:
System Type:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TEI LT-3
Red Jacket
Pressure
50
l:15:00 AlvI
1:30:00 AM
t70
168
0.002
PASS
4
i
i*I, #ffi$
ii&mf8ii{F,S*ffi i*#Sff&.#
Triangle Environmental, Inc.
T.E.I. SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT
Facility: Circle K #07844
Tank #: 4
Product: Unleaded Premium
Test Date: 3/10197
\York #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. of Expansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. (F):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
6016
96
78
5235
87.UYo
0.730
0.000697
0
0
47.9
2.t
6:00:00 PM
2:00:00 AM
0.04
PASS
Test Method:
Manufacturer:
L/D Model:
L/D Serial #:
Line Drain Back (ml):
L/D Trip Time (sec):
Holding Pressure (psi) :
Metering Pressure @si):
L/D Test Rate (gph):
L/D Result:
R.J. FTA
Red Jacket
)(LP
50491-2320
300
J
l5
18
4.0
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum (psi):
IJllage Result:
T]LLAGE
781
8:12:00 PM
I
PASS
TestMethod:
Pump Brand:
System Type:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line StartLevel:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TEI LT.3
Red Jacket
Pressure
50
t2:10:00 AM
12:25:00 AM
206
200
0.006
PASS
5
iffi l$U#n&,D,n,{ffiGlI:A iifif,Slff r*$$*Ii}tr
iiffi
#"ffi.J.ixr.#s.ff;:ffi:s
iffiB
Triangle Environmental, Inc.
T.E.I. SYSTEMS TAIYK, LINE AND LEAK DETECTOR TEST REPORT
Facility: Circle K #07844
Tank #: 5
Product: Unleaded Regular
Test Date: 3/10197
Work #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. ofExpansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. @):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
10152
96
75
8509
83.goh
0.730
0.000701
0
0
48.22
2.0
6:00:00 PM
2:00:00 AM
0.013
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum (psi):
Ullage Result:
T]LLAGE
1643
8:20:00 PM
I
PASS
TestMethod:
Manufacturer:
L/D Model:
UD Serial #:
Line Drain Back (ml):
L/D Trip Time (sec):
Holding Pressure (psi) :
Metering Pressure (psi) :
LID Test Rate (gph):
L/D Result:
R.J. FTA
Red Jacket
)(LP
40889-3135
250
3
7
18
4.0
PASS
TestMethod:
Pump Brand:
System Type:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TEI LT.3
Red Jacket
Pressure
50
9:35:00 PM
9:50:00 PM
174
170
0.004
PASS
6
xfriEilr*ru#,ffi #ffi iiffi *uffid
Lffi
t::i
i,IrH.{SiL,ilff $Srifi Sl$ffi ff
lffifiillI*S#iffi
Triangle Environmental, Inc.
T.E.I. SYSTEMS TANK, LINE AND LEAK DETECTOR TEST REPORT
Facility: Circle K #07844
Tank #: 6
Product: Unleaded Plus
Test Date: 3/10197
\[ork #: SM80093
Test Method:
Capacity:
Diameter (in):
Product Level (in):
Liquid Volume (Gals):
Liquid Percent (7o):
Specific Gravity:
Coef. ofExpansion:
Water On Tank (in):
Water In Tank (in):
Product Temp. @):
Head Pressure (psi):
Test Start Time:
Test End Time:
Test Rate (gph):
Test Result:
System 4000
10152
96
74
8397
82.7o/o
0.730
0.000697
0
0
49.38
2.0
6:00:00 PM
2:00:00 AM
0.023
PASS
Test Method:
Manufacturer:
L/D Model:
L/D Serial #:
Line Drain Back (ml):
L/D Trip Time (sec):
Holding Pressure (psi):
Metering Pressure (psi) :
L/D Test Rate (gph):
L/D Result:
R.J. FTA
VMI
\1PR
58078
200
2
20
l8
3.0
PASS
Test Method:
UllageVolume (gals.):
Ullage Test Time:
Ullage Vacuum (psi):
Ullage Result:
ULLAGE
1755
8:32:00 PM
I
PASS
Test Method:
Pump Brand:
System Type:
Line Pressure (psi):
Line Start Time:
Line End Time:
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
TEI LT.3
Red Jacket
Pressure
50
ll:17:00 PM
11:32:00 PM
105
102
0.003
PASS
leak detector
7
$ff
ffi
tffi
iffiil #.ffi
Triangle Environmental, Inc.
2525 West Burbank Boulevard, Burbank, California 91505
[phone] FAX (81S) S4o-692e
.E.1. UST FACILIT I ACILITY INSPECTION/AUDIT SH
X'acility:
Circle K #07844
506 E STATE
AMERTCAN FORK, UT 84003
County: UTAH
Cross Street: E. STREET
Test Date: 3ll0l97
Work #: SM80093
Status
N=NotPrcHtGObfficd
S= Sadrfrclory
U= Unsdrfectory
Fill Cover: S
Fill Cap: S
Fill Cap Seal: S
Drop Tube: S
Strike Plate: N
VIR Cover: N
V/R Cap: N
V/R Seal: N
V/RDry Break: N
Sub Pump: S
Sub Pump Cover: S
Overfill: S
Overfill Mfgr:
Fill Type: N
Product Line Type: P
Tank SwingJoint Type: N
Dispenser Swing Joint TYPe: M
Status
N= Noa Prrrcnt
S= Srdrhciory
U= Unr.tkfaclory
Impact Valve: S
Vertical Check Valve: N
Fill Spill Containment: N
Fill Spill Mfgr
DispenserContainment: N
Sub Pump Containment: N
Stage II
B=BrhE
A- Atltt
System Type: N
Assist Mfgr:
Type
C= Ccdd
I)- Drld
N= NcStrgpl
P= Prorw
A= Anghcbc-lr
Y= Vcrllelchcdt
F= Fbr
Mc M:trlc
Number of
Regular:
Plus:
Premium:
Diesel:
Kerosene:
Hoses
6
8
6
0
0
Disp.
4
6
4
0
0
Comments:
Compliance Detail: (List items that need immediate attention.
Triangle Environmental, Inc.
2525 Wesl Burbank Bouleverd, Burbank' Cslifornia 91505
(8rt) 840-7020 rAX (81t) 840{929
T.E.I. UST WORKSHEET SUMMARY SHEET
Client:
TOSCO MARKE'TING COMPANY
3550 N. Central Ave., 4th Floor
Phoenix, AZ 85012
Facility:
Circle K #07844
506 E STATE
AMERICAN FORK UT 84003
Date: 3ll0l97
County: UTAH
Work #: SM80093 Repairman
Work D$cription I
Replaced leak detector on lOK IJLP
Work Description 2
Parts List
Qty Descriplion
\.PR
Steve Martin LaborHours:
Item #1: I
Item #2:
Item #3:
Item ,r4:
Item #5:
Item ,16:
Item #73
Item #8:
Item ,19:
Item #10:
Item #11:
Item #12:
Leak Detection Certification(s)
APPENDIX D
APPENDIX E
CP Upgrades Report
KNOLOG
r t, ,ihr) i )(i, f 1)R tANrS
.\:.J1] I r,i 1F L\VIqONMtNT
COMPLIANCE SURVEY REPORT
d Current Cathodic Protection
UST SYSTEM
lmpresse
FOR:The Circle K Corporation
9O6 East Anderson Lane
Austin, TX 7S752
ATTN: Mr. Ken Younger
SITE:Store #7844
506 E. State
American Fork, UT 84OO3
BY: Tanknology Corporation lnternational
R bert E. Hall, P.F.
Corrosion Engineering Manager
(NACE Corrosion Specialist #1320l,
october 23, 1996
Job# 08280
PEI
TA IIK NOLOGY COR POFATION INTEF NA] IONA.
5225 Holtister St . Housron. Texas 770 40-6294 . 1713\ 690'8265. 1 (8OO) 888-8563 . Fax: [phone]
COMPLIANCE SURVEY
The Circle K Corporation
Store #7844
506 E. State
American Fork, UT 84003
I. SCOPE
A cathodic protection survey was conducted on 10-05-96, on the
cathodic protection system at Store #7844,506 E. State. American Fork,
UT. The purpose of this survey was to meet regulatory requirements for
periodic testing, and, more importantly, to determine if the cathodic
protection system at this facility meets NACE criteria for cathodic
protectir,r, NACE criteria indicates if the systern is f unctionally
controlling corrosion (see Appendix l).
The cathodic protection system for the underground tanks consists
of eight EZ-SS-64 anodes energized by one 80 volt-O8 amp SSP-CCrectifier The UST tacility consists of one 6,00o-gallon and two
1O,000-gaii<.'r' STI-P3 tarrks, and three 12,OOO-gallon steel tanks and
assoeiated piping. Cathodic protection installed on steel tanks oniy.
II. RESULTS & ANALYSIS
The structure-to-soil potential measurements are tabulated on Table
l, and the rectifier and anode current outputs are tabulated on the
Rectifier Maintenance sheet, attached.
The rectifier was adjusted and set at a total constant current output
of 6.6 Amps t 5%. The potential measurements, with the cathodic
protection system energized, ranged from -977 millivolts to -1842
millivolts.
III. CONCLUSIONS
The results of the survey indicate that the structure-to-soil potential
measurements meet the -850 millivolts criterion and/or the 100 millivolts
1
COMPLIANCE SURVEY REPORT
lmpressed Current Cathodic Protection
cathodic polarization criterion for cathodic protection as established by
NACE.
It is recommended that the rectifier output be observed monthly.It is also recommended that a structure-to-soil potential survey be
conducted annually by a qualified corrosion engineer. The cathodic
protection system should operate with minimal maintenance and it is not
recommended that any spare parts be kept on hand.
V. REGULATORYREOUIREMENTS
Federal and State regulations require cathodic protection systems to
be checked periodically. (Reference: 40 CFR, Part 28O, I 280.31,
"Ol.reration and Maintenance of Corrosion Protection".)
All cathodic protection systems must!+ be surveyed (tested)
every three (3) years,
The cathodic protection system must be inspected and tested
within six (6) months after any repairs to the UST system.
(Reference: 40 CFR, Part 28O, 5 280.33, "Repairs Allowed".)
All impressed current systems must be inspected every 60
days to see that they are functioning properly. lnspections
must be logged (documented).
a
O
a
a Within six (6) months after initial turn-on of an impressed
current system, it is required that a General Survey be
conducted and any necessary adjustments made.
' To meet minimum regulatory requirements. lt is good
practice to conduct such surveys annually.
2
IV. RECOMMENDATIONS:
APPENDIX I
TEST PROCEDURES
ln order to determine the effectiveness of the cathodic protection
system, structure-to-soil potential measurements were performed at
representative locations throughout the sub.iect area. These
measurements were collected after the cathodic protection system was
energized. These measurements are then evaluated to determine if an
adequate level of cathodic protection has been achieved.
The two (2) most common criteria for cathodic protection as
established by the NACE standard RP-02-85 "Recommended Practice -
Control of External Corrosion on Metallic Buried, Partially Buried, or
Submerged Liquid Storage Systems" are as follows:
A negative (cathodic) voltage of at least 0.85 volts as
measured between the strticture surface and a saturated
copper/copper sulfate reference electrode containing the
electrolyte. Determination of this voltage is to be made with
the protective current applied.
A minimum negative (cathociic) ,rolarization voltage shift of
1 00 millivolts measure,.l betrryeeir the structure surf ace and a
stable reference electrode contacting the electrolyte. This
polarization voltage shift is to be determined by interrupting
the protective current and measuring the polarization decay.
When the current is initially interrupted, an immediate voltage
shift will occur. The voltage reading after the immediate shift
shall be used as the base reading from which to measure
polarization decay,
These potential measurements were obtained, utilizing a
copper/copper sulfate reference electrode and a Fluke, Model 87 Digital
Multimeter,
1
2
TANKNOLOGY
CORROSION SURVEY - FIELD DATA AND TABLES TABLE I
Shaet 1 of 1
CLIENT: The Circle K Corporation STRUCTURE-TO-SOIL POTENT!ALS
UST FACILITY: Store #7844, 506 E. State , American Fork, UT vs Cu/Cu SOn
DATE OBTAINED: 1O-05-96 (Millivolts)
SURVEYED BY: JS
NO
1 PLUS UNLEADED UST TANK .1 099
STP -lo99
2 PREMIUM UNLEADED UST TANK -977
STP -977
3 REGULAR UNLEADED UST TANK -1588
STP -l588
4 VENTS -1 595
2 -1 595
3 -1 595
5 1&2DISPENSERS -17 48
3&4 -1754
5&6 -1842
7&8 -1775
)
)
ltttltttttttltrtttt
' ' l-o(
:'ffir_T
Narn/F I
I
i
TANKNOLOGY
CATHODIC OTECTION RECTIFIER MAINT ANCE SHEET
Rectifier Unit No Store #7844
Location of Rectifier Unit Flenlr Pnnm
Type of Rectifier Unit: Silicon Controlled Rectifier
Tvpe of Anodes: EZ-S5-64 of Ground Bed : Distributed Surface Bed
No. of Anodes: 008 Size: 0,9" AX 64" Lo
Ground Bed Locatio n: Around Tanks
Rectifier Mfg. By: Tanknoloov Model: SSP-CC SN # 950579
Rectifier AC lnput : 12O V olts, 10 Amperes,_l_Phase, 60 Hz
Rectifier DC Output: 80 Volts, 08 Amperes,_L,1Q$_Shunt: 50 mv : 10A
lnstalled:_ Tanknoloov - 03.26-96
i. OmmentS
Rectifier
Serring Date
20.26 6.6 i 0-05-96 JS OK
By Bemarks
7t
TCDSG(o
MarketingCompany
August 18, 1997
Mr. Bruce Hagans
Division of Environmental Response and Remediation
Utah Departmentof EnvironmentalQuality
168 North 1950 West
P.O. Box 144840
Salt Lake City, Utah
RE: RELEASE SITE EKDB TANK AND LINE TESTING RESULTS
Circle K Store #7844
506 East State Skeet
American Fork, Utah
Facility lD Number: 1000054
Dear Mr. Hagans,
This letter transmits the results of tank and line testing completed recently at the above
referenced site. This work was completed in response to a potential release at the site reported
to you on July 19, 1997. The suspected release was reported based on inventory control
record discrepancies.
ln response to the inventory problem, tank and line testing were completed on August 1, 1997
by Triangle Environmental, lnc. The two tanks and associated product transfer lines passed the
tests run by Triangle. A copy of the testing results are attached.
Based on the tank testing results and further inventory record review it appears the inventory
discrepancies were the result of poor tank data collection by store personnel. Based on this
information we feel that Tosco Marketing Company has met the requirements in accordance
with Utah Admin. Code R311-202 Part 280, Subparts E and F. as referenced in your
"Subsurface lnvestigation Reporting Scheduling and Requirements" letter dated July 30, 1997.
lf you have any questions, please contact me at [phone]
Richard A. Larson
Project Manager
cc.
3550 N. Central Ave.
4th Floor
Pho6nlx, AZ 85022
602-200.47o0
fax: 602.53O.Soaa
Very truly yours,,z/o/.-"-
Ruth Bulmer, Compliance/File
B@@gg t'
!irv-r\! rll,!Ll.
Triangle Environmental, fnc.
2525 West Burhmk Boulevard, Burbanlq California 91505
(Er8) E4G7020 FAX (EtE) 340{929
T, E, I. US r TE S TIN G .Sr.SrfiM^S SUMMARY SHEET
Precision Underground Storage Tank Systcm Leak Test
Clientr
TO SCO I\4ARKETING CoMPA}.TY
3550 N. Cenkal Ave., 4th Floor
Phoenix, AZ 85012
Carmen Tucker
[phone]
Faciltty:
Circle K #07844
506 E STATE
AII{ERICAN FORK, UT 84003
Trak
#Product Crprclty
Circle K #07844
Test Date: 8/ I/97
lYork#;4100994
County: UTAH
Cross Street: E. STREET
3 Unleaded R^egular
5 Unleaded Regular
12032
10152
VPLT
VPLT
Test Syrten
TypG
Trnk
RrtclRerults
0"003 PASS
0.003 PASS
Ullrge Result
PASS
PASS
I"loe
Ra*/Rerull
0.002 PASS
0.002 PAss
I/Il tresult
PASS
PASS
Certilicd Ey:Technicisn; NDE
Mfgrrs #:
Strte Lic. #s:
Comments:
NDE tested by David sreinberger ricense number ur0247. out of compliance trNL
This precision tank testing syrtem has beGn third
procedures for aunual leak detectiou systernc and
gph wtth a Pd >957o and pfs <fyo as required by
Part 280 for precision testtnE systems.
party evaluated according to the guidelinw of the EpA
, fouud to exceed the criteri* of dete+,fing s lcsk of 0.10
Locat, State and Fcdergl EPA UST Tecinicel Stendsrdr
f H\.fE- U ij
Triangle Environmental, Inc.
T.E.I. SYSTEMS TANK, LINE ATID LEAI( DE'IECTOR TEST REPOR
Facility: Circle K #07844
Tsnk#: 3
Product: Unleaded Regular
Test Date: 8l I/97
lVork* 4100994
Test Method:
Capacity:
Diameter (in):
Product Levet (in):
Liguid Volume (Gais)r
Lieuid Percent (96):
$pecific Gravity:
Coef. of Expansion:
Water On Tarrk (in):
Water In Tank (in):
Product Temp. (F):
Head Pressure (psi):
Test Start Time:
Test Ehd Time:
Test Rate (gph):
Test Result:
VPLT
12032
96
59
7755
64.5%
0.710
0.000654
0
0
t,5
3:35 AM
6:36 AM
0.003
PASS
Test Method:
Manufactuer:
I-tD Model:
L/D Serial #:
Line Drain Back (ml):
UD Trip Time (sec):
Holding Pressure (psi):
Metedng Pre.ssure (psi):
L/D Test Rate (gph):
L/D Result:
R.J- FTA
Vaporless
LD2000
47616
154
?
29
10
4.0
PASS
Test Method:
UllageVolurne (gals.) :
Ullage Test Time:
Ullage Vacuum (psi):
Ullage Result:
ULLAGE
4277
3:10 AM
2.5
PASS
Test Method:
Pump Braud:
System Tlpe:
Line Pressure $si):
Liue Stsrt Tiee:
Line End Time:
Line Start Level:
Lins End Level:
Line TestRate lgph):
Line Test Result:
Peto-Tite
Red Jacket
Pressure
50
6:15 AM
6:45 AM
50
48
0.002
FASS
2
UIU UlU qJA,J I t\1Ht i\li-c. E l.{u ll\u f I {u rAhL E4
Triangle Environnrental, Inc.
T.E.I. SYSTEMS TA}[K, LINE AND LEAK DETECTOR TEST REPORT
Facilityr Circ,le K #07844
Tank #: 5
Product: Unleaded Regular
Test Date: 8l tl97
Work#:4100994
Test Method:
Capacity;
Diameter (in):
Product Level (iu):
Liquid Voiume (Gals):
Liquid Percent (%):
Specific Gravity:
Coef, ofExpansion:
Water On Tark (in):
Water [n Tank (in):
Product Temp. (F):
Head hesswe (psi):
Tesr Staf,r Time:
Test Ead Time:
Test Rate (gph):
Test Result:
VPLT
10152
96
54
5t83
57.9%
0.71o
0.000654
0
0
1.4
2:25 AM
5;25 AM
0.003
PASS
Test Method:
Manufacturer:
LID Model:
L/D Ssrial #:
Line Drain Back (ml):
L./D Trip Time (sec):
Holdins Pressure (psi):
Metering kessure (psi) :
["/D Test Rate (gph):
LID Re.cult:
R.J. FTA
Vaporless
LD2000
580t2
r54
_{
)7
l0
3.0
PASS
Test Method:
Pump Brand:
System Type:
Line [tessure (psi):
Line $tart Time:
Line End Time;
Line Start Level:
Line End Level:
Line Test Rate (gph):
Line Test Result:
Pebo-Tite
Red Jaclset
Prcgsure
50
5:43 AM
6:13 AM
.50
48
0.002
PASS
Test Method:
UllageVolume (guls.):
Ullage Test Time:
Ullage Vacuum (psi):
UUage Result:
ULLAGE
4269
I r57 ANI
2.4
PASS
)
Triangle Environmental, Inc.
2525 West Burbauk Boulcvard, Burbank, Califomia 9lS0S
(818) 84G7020 FAX (81$) 84M929
T,E.T. AST WORKSHEET SAMIIIARY SHEET
Client:
TOSCO MARKETING COMPANY
3550 N, Celhal Ave., 4th Floor
Phoenix, AZ 85012
Facility:
Circle K #07844
Ilate: 8/ 1,/97
Circle K #A7844
506 E STATE
AMERICAN F0RK, ur B4oo3 county: urAH
Work#: 4100994 Repairrnan; I{DE LaborHouns:
Work Descriptlon l:
Replaced ieak dotector on UNL
Work Description 2:
Parts
Descrlptlon
LDz000
Qty
Item #1r 1
Item #2:
Item #3:
Item #4:
Item #5r
ltem #6:
Item #7,
Item #8:
Item #9:
Item #10:
tten #LX:
Item #12:
Triangle Environmental, Inc.
2525 Weet Bqrtrnk Boubvsrq Burb8nlq Cellfuraia 91505
(818) &t0-7020 FAX (816) 8{}{929
R-*-A [i*uro e&
q a
{t"*18\q
P w
oLoGr{'"1 0 0 oo ry RFep,u*b"
TECHNOLOGY FOR TANKS
ANO THEIR ENVIRONMENT
Ocr 2 B tgg6
_ Centra, Flegron
trnvtronmental Departmen t
r
t
COMPLIANCE SURVEY REPORT
lmpressed current Gathodic Protection
UST SYSTEM
FOR:The Circle K Corporation
906 East Anderson Lane
Austin, TX 78752
ATTN: Mr. Ken Younger
Store #7844
5OO E. State
American Fork, UT 84003
BY: Tanknology corporation lnternational
R o bert E. Hall, P.E.
SITE:
Corrosion Engineering Manager
(NACE Corrosion Specialist # 1320]l
LI
October 23, 1996
Job# 08280
atflilalt
TANKNOLOGY CORPORATION INTERNAT IONAL
,PEI=
5225 Hollister St. . Houston, Texas 77040-62g4 . (7131 690-8265 . 1 (800) 888_8563 . Fax: (71 3) 690_2255
t
I
COMPLIANCE SURVEY
The Circle K Corporation
Store #7844
SOG E. State
American Fork, UT 84003
I. SCOPE
A cathodic protection survey was conducted on 10-05-96, on the
cathodic protection system at store #7844, s06 E. State, American Fork,ur. The purpose of this survey was to meet regulatory requirements forperiodic testing, and, more importantly, to determine if the cathodicprotection system at this facility meets NACE criteria for cathodicprotection. NACE criteria indicates if the system is functionally
controlling corrosion (see Appendix t).
The cathodic protection system for the underground tanks consistsof eight EZ-SS-64 anodes energized by one gO volt-Og amp SSp_CCrectifier. The usr facility consists of one 6,000-gallon and two
1O,Ooo-gallon STI-P. tanks, and three 12,Ooo-gallon iteel tanks andassociated piping. cathodic protection installed on steel tanks only.
II. RESULTS & ANALYSIS:
The structure-to-soil potential measurements are tabulated on Tablel, and the rectifier and anode current outputs are tabulated on theRectifier Maintenance sheet, attached.
The rectifier was adjusted and set at a total constant current outputof 6'6 Amps + 5%. The potential measurements, with the cathodicprotection system energized, ranged trom -g77 millivolts to -1g42
millivolts.
III. CONCLUSIONS
The results of the survey indicate that the structure-to-soil potential
measurements meet the -850 millivolts criterion and/or the 1oo millivolts
1
(
I
COMPLIANCE SURVEY REPORT
lmpressed Current Cathodic Protection
cathodic polarization criterion for cathodic protection as established by
NACE.
It is recommended that the rectifier output be observed monthly.It is also recommended that a structure-to-soil potential survey beconducted annually by a qualified corrosion engineer. The cathodicprotection system should operate with minimal maintenance and it is notrecommended that any spare parts be kept on hand.
V. REGULATORYREOUIREMENTS:
Federal and State regulations require cathodic protection systems tobe checked periodically. (Reference: 40 CFR, iart 2gO, S' iAO.Sl,"Operation and Maintenance of Corrosion protection".)
' All cathodic protection systems must" be surveyed (tested)
every three (3) years.
o The cathodic protection system must be inspected and testedwithin six (6) months after any repairs to the UST system.(Reference: 40 CFR, part 2gO, S 280.33, "Repairs Allowed*.)
. All impressed current systems must be inspected every 60days to see that they are functioning properly. lnspections
must be logged (documented).
Within six (6) months after initial turn-on of an impressedcurrent system, it is required that a General Survey beconducted and any necessary adjustments made.
* To meet minimum regulatory requirements. lt is goodpractice to conduct such surveys annually.
a
2
IV. RECOMMENDATIONS:
I
ln order to determine the effectiveness of the cathodic protection
system, structure-to-soil potential measurements were performed atrepresentative locations throughout the subject area. These
measurements were collected after the cathodic protection system wasenergized. These measurements are then evaluated to determine if an
adequate level of cathodic protection has been achieved.
The two (2) most common criteria for cathodic protection as
established by the NACE standard Rp-02-85 "Recommended practice -control of External corrosion on Metallic Buried, partially Buried, or
Submerged Liquid Storage Systems" are as follows:
APPENDIX I
TEST PROCEDURES
A negative (cathodic) voltage of at least 0.g5 volts as
measured between the structure surface and a saturated
copper/copper sulfate reference electrode containing the
electrolyte. Determination of this voltage is to be made with
the protective current applied.
1
2 A minimum negative (cathodic) polarization voltage shift of
100 millivolts measured between the structure surface and a
stable reference electrode contacting the electrolyte. This
polarization voltage shift is to be determined by interrupting
the protective current and measuring the polarization decay.
When the current is initially interrupted, an immediate voltage
shift will occur. The voltage reading after the immediate shift
shall be used as the base reading from which to measure
polarization decay.
These potential measurements were obtained, utilizing a
copper/copper sulfate reference electrode and a Fluke, Model g7 Digital
Multimeter.
\
TANKNOLOGY
CORROSION SURVEY - FIELD DATA AND TABLES TABLE I
Shoet 1 of 1
The Circle K CorporationCLIENT:STRUCTURE.TO-SOIL POTENTIALS
UST FACILITY: Store #7844, 506 E. State, American Fork, UT vs Cu/Cu SOo
DATE OBTAINED: 1O-O5-96 (Millivolts)
SURVEYED BY: JS
1 PLUS UNLEADED UST TANK -1099
STP -1099
2 PREMIUM UNLEADED UST TANK -977
STP -977
REGULAR UNLEADEO UST TANK -1 588
STP -'t 588
4 VENTS
-1 595
2 -1 s95
3 -1 595
c DISPENSERS 1&2 -1748
3&4 -1754
5&6 -1842
7&8 -1775
,|
A
TANKNOLOGY
cnruoolc pnorecfl
Rectifier Unit No.Sfnra F'44-
Location of Rectifier Unit: Back Room
Type of Rectifier Unit q;t Cnntrollprl Flontifiar
Type of Anodes: EZ-SS-64 Type of Ground Bed l)iefrihr Srrrfaee Borl
No. of Anodes: 008 Size: 0.g" gx___64.__Long_
Ground Bed Location Arnrrnr{ T nks
Rectifier Mfg. By: Tanknoloov Modet: SSp-CC SN #95057 9
Rectifier AC lnput: 120 Volts, 10 Amperes, I phase, 60 Hz
Rectifier DC output: Bo Volts, OB Amperes, 1CKT Shunt: 50 mv = I0A.
ln
Comments:
20.26 6.6 10-05-96 JS
(
OK
I
I
To.co lLrk.tlng Comp.lry
3Ii5O N. Contlat Ave.. Slh Ftoor
Pho€nix, Arlrooa 85Ot2
T€l€phono: 6O2-20(H700
Fecaimlle: 602-2@-4520
TOSCO E HAND DELIVEREo ltlly 7,1997
State of Utah Dept of Envtuonmental Quality
Division of Envitpnrrrental Responee and Remediation
Attentioru Mr. Kent P. Grdy
168 Nofth 1950 Weet
Salt Lake City, Utah M114484{,
RE:Certificate of Compliancc Requirements for Cathodically Prctected UST's
Facility ID NOS:sflXXt3% 9fiXXI19, 5(XXX!40, 1fiX,051,
1qrc053, (XXIr54 1Ux)054 7urc065
Dear Mr. Gny:
Tosco Marketing Co'npany dba Circle K Stol=e Inc. ("we"), strivee to rrmain in compliance
with all regulatory agencies and appr,eciates your fune lt 1997 letter which was specific to
Facility 10ffi053 but applicable to other facilities noted above.
Mr. Bill Moor,e notified me in May of this year that Tanknology's uae of Petnscope prior to
February X,1997 was dfuapproved by the State of Utah and we must now pedorm one of
several techniques in order to gain a compliance status for the UST'a at affected facilities
where Petrcscope was utilized between Febmary 1993 and March 1996. I then diecugsed this
mafter l^ ith Bud Mattox at Tanknology/NDE an4 on May 27 , rtrlade a f ottrahequest for
Mean Time to Conosion Failune analyses (M[CD be perfonned and rcsults sent to me within
60 daye. I anHcipate that your agency will receive MTCF rrports prior to the August 13, 1997
deadline.
AE Bt ted in your lettel, failure to resolve the conpliance problems by that date will result in
revocation of the Certificate of Compliance at affected facilities and they will be ineligible to
receive any fuel deliveries until full compliance can be demonstrated.
Please contact me if you have any questions orconcerns.
Respectfully,
,(a,f Z-Z*-
Ruth H. Bulmer
Compliance Specialist, Southwest Region
{attachment
cc:Myron Smith
Don Esperson
Bob Staab
Bill Moore
Rich Laleen
Bud Mattox
JUN 19'97 9:37 N0.003 P.01
loooofi
STORD INFO:
PRODUC?
BDPORTF)DTO:
UTAH RELEASE REPORT FORM(cxlIATI,:!, lrcrt srrl.pECTID )qrLuAsE BUIOnTINc oNIJi
_clncl.E K STORU #7844, ID #1000054
-606 E. SI)ATE, AIVIEBICAN rOIrK UTAH
UNLEADED*.PaoDUCT (TANr(s #3 AND#5) ._(t.nk or llnc)
DEPT. OF ETWTBoNMDNTAL QUALITYDryTSION OT' DNVIRONMBNTiL RI,SPONSDANDIIEMEDIATION
FAl( Nt MBDR: (80t)869-866a
DATI: REP_O-RTtsD I_,.JUNE 19, tggz._
DATE DIScOVIIBED:, _JUNE rs, rds-z_, gaM:
RI,SULTS SEN?'I() YOUN OFFICDAS SOON
DES CBI PTION OIi. INCIDI,NT:
IIIONIH-END I NVENMRYVARIANCI:S FOB APRIL AND MAY 1997-T)XCEDDI}D THI, FEDDITAL AI,LOWABLE LI MITOF I%THRUPUTPI,US I8O GALI.ONS, 'A USTSYSTEM WILL BI' SOHF:DULNT)AND
ASAVAII,ABLE.
COMPANYCONTACT: RUTHBULMER
COMPLIANCD SPECIALIST
P. O. BOx5208{, PHOEND(, AZ E6072
PHOND: <802)200-4621
CONSULTANT: _N/A_
NMENTAL RISPONSE & REM
DERR
ENI[.RED
ENVIRO
q
r0!ATl0N
NITI ALs-fl&_
ID:
f ooo\ry
DEPARTMENT OF ENVIRONMENTAL QUALITY
DTVISION OF ENVIRONMENTAL RESPONSE AND REMEDIATION
Michael O. kavitt
Governor
Dianne R. Nielson, Ph.D.
Executive Director
Kent P. Gray
Director
168 North 1950 West
P.O. Box lul4840
Salr take City, Utah 84114-4840
[phone] Voice
[phone] Fax
(801) 5364414 T.D.D.
June25,1997
TO:
Circle K Convenience Stores
906 E Anderson Ln
Austin, TX78752
Underground Storage Tank Section
Janet J. Keller
Environmental Scientist
RE Non-compliance of underground storage tanks at Utah County Iocations
Facility I.D. # 1000400,1000055, 1000053, 1000371, 1000368, 1000054, 1000051
To continue to maintain valid Certificates of Compliance, each facility must be in compliance with
Federal and State Rules and Regulations. Compliance reviews, performed on_UNIlg'\, indicate you
have not satisfied the requirements of the Act and are out of compliance. To achieve compliance you
must do the following:
Submit evidence that proper Monthly Statistical Inventory Reconciliation (SIR) is
performed on USTs at facilities 1000400, 1000055, 1000053, 1000371,1000368 by:
a. Documenting that inventory records for product inputs, withdrawals, and the amount still
reading in the tank are available for each operating day.
b. Documenting that the records include the correct number of monthly water monitoring
readings.
c. Documenting that SIR records are available for the past 12 months.
2. Submit documentation to show that you have had a qualified cathodic protection tester test
your cathodic protection system within the last three years at facilities L000054 and
1000051.
3. Submit documentation to show that the impressed current cathodic protection system is
inspected for proper operation every 60 days at facilities 1000054 and 1000051.
I
u,*q9.
Page 2
The above information must be submitted to this office by_09130[. 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 Janet Keller at
(80t) s36-4r2t.
reumo/Alnlc3 -,v\otPA'u8lo-euq/\ :uoDnq!rl5r0
e^sq I leql llluec Y11"vi\
sueuuroS
eql \,{rrtAr/\
6ufno lueseld g^llau€so/dou srreu/l O ro JoU/\^O Jo srnleuors
uo AtrtrceJ
:orn$u6ts s,.ropedsul
b/
I ^rolus ul lecllsltelsISIsi uolrElllsuoJEs
O.UTJOIIUOUIFIIIISJSIUI
orJrn)lluox[n'Isfiplnoj5
DUUOITUOy{ JOOBA
<.-DuEsol ssoulqDrl Eu!'I
P.i:!s$li#lfl.qlF#:i
ii::'ii:i.'rilililililiriiliii:it!li::,.rii:i:iiiiii
tffiE.ffi.rlJlffii
i*:!:!::rg*i*I*::::ri:::t
rO,5'JI'O IEET
{ulsl uo[Elll9uocg8 ArcIls uI Isc.rJsr-IEts
ou!ro1!uot/{ lBltllsrolul
uu.I,ol.IuoxIJ6lEmpuno]si
D(nJolruOhl .IOalEA
DUlOne0 luPl lenueyl
D-UrDnES.IUqI fls
oullsel sseulqDrl lugulo4uo3 ruolus^ul
<-
-dJj
{ c}o 'd8l 'lsEls) Du.-.dr6]o uolclfllsloulul<-
-
l"d$,{'ors 'dul 'les$} lusl lo uotl5n[.uo5 lo ISTJEIEW
l,r,r :.lq!sx td F.2l.r l.l t xv-n <1 ,rld paroF ocuBlsqns
>q Yat >l0 t :fe,)bI )dl {suollsu ulxssflo II.rJFdEJi<-* ,t!,t 1-_ €Bb\Pollelsur luE] 186^ puB qluol l
IS9q5U! UTW
pssn ]sBl stsp 'asr ulloul
ON AEA-oN ssllu.rrlluErElquEl
oN oN Ea^^.2 ecuBlpuro9 ,o olBclrruoJ uo psl8ll iuEI
eIE uo acuBlldtlo3 lo olBcUlUgJ
opo3 dlz
sserppv le9rls
lr!3JJ'l
"r"rdF
vt'f9:olBp uolsJtdx3
d)n ,$uno3
u) U127l-^?tLti_-l v2 quY
>l 1l' ' )r I
".,"" a,,,"",
t^IllusIlEqusr
EL.
# ouoqd
epoS Berv,lgqurnN euoqd
elBlsepo3 dtz
7
Ir!3
$erppv
7yq7A
uollBcol lsn lv uosred lcsluoc
IIIII IIIIIIII I
-
IIIIE,--ElI-Iffiffi --I
I'!c
IIITIIIIIIIIIIIIIIIIIIIIIIII
-II--r-E-IIIIffiffirI--
-=:I-EIII
-r--II-
I III II
IEE E15 H =ssel
=g=rgtH
-zl09
{Poq}su.r lo Bureu a}BcrPurt Poqlour pg^olooE ,oqlo
our3N reuMo
Tank I fank2 3 r)nr*1 { rtnrl L>
Yes No Yes NoYes@-The UST system is filled by transfers of 25 gallons or less. lf yes, spill
and overfill prevontion is not required.
Yes No Yes NoYes@-ls there a spill containment bucket or another device that will prevent
release of product into the environment?
No
Yes No Yes NoNo
b"W^+Vz!,u"et:\
ls there an ovorfill prevention device installed on the tank? lf yes,
indicate the type of device: Ball float (in vent line), Automatic shutoff
(in fill pipe), Alarm, or Other (specify)
Yes No YesYes No No NoFor overlill alarm only: ls the alarm located where it can be easily
seen and heard by the delivery driver?
Tank I
Yes No
Tank 2
Yes No Yes
IA rk3
No NoFor overlill alarm only: ls the alarm clearly marked to indicate what is
meant when the alarm sounds?
I Lr*T!r*TC-Tar*Tr*
Llm I m
FRP
Um Llm
lndicate tho type of corrosion protection: Noncorrodible material (FRP),
Composite steel (CS), lnternal lining (lL), lmpressed Current (lC),
Sacrificial Anode (SA), or Not protected (NP). It FRP or CS do not
complete the remalnder of thls section.
Yes No Yes No Yes No Yes No
lf the UST is not protectsd, was the tank/line installed before May 7,
1985? It yes, cotrosion Protection is not required until Dec. 22,
1998; do not complete the remainder ol this eection.
Yes No Yes No YesThe results of the last two cathodic protection tests are available.
(within 6 months of installation and every 3 years thereafter).
No Yes No
\
Tank
volts
TMK
volts
mk
volts
Tar ,\,o
Um
volts
Um
volts
lm
volts
Ur
Results of the most recent cathodic protection t€st.
Name of
Test nata.
nJn.
V;ue!
Yes wFor impreseed current system: The results of the last three
equipment operation checks are available. (Equip. check required every
60 days.)
4?
Yes No Yes No Yes
-;
No
Datelnspector's
I
! Overfill prevention for for tank(s)
understand that the following marked items must be completed by
lf the tank has been retrofit (lined or cathodically protected), indicate
the date the retrofit was completed.' t tlvt ..rnt-e-.,-- <l tro
Signature of Owner or Owner's Representative Pres€nt During lnspection
! Corrosion protection for piping assoc. with tank(s) #o-.9..e Facility requirements
(rtldlIm)
December 22,1998 in order to meet the 1998 upgrade requirements:#pittprevention fortank(s) n ,il
,
Distribution: WhiteDERR,
lilll:rlj;:::::::::::: i r.:i:ri:::,::.:r:r::::::::::::::::ji:
,U$trl,fiH$UH#ttiliiii ,::t,tlitirii:iiir:iii,,r:ir,;iiiii
:::::::F'#Slllfyi
GftffiIdT$T:Ov€ffi11,And,,-G6}t i6rr
,fffis:ds 'lt,Pt6ase ll6rG Ilnla ton:$I r
tHE,.r$tHl$fl
CORROSTON PROTECTION
^^--^^a^.
UPGRADE NOTIFICATION
This method of leak detection requires both monthly inventory control reconciliation and tank tightness testing. lf the UST has not been upgraded
(upgraded means that the tank and piping are protected from corrosion and that spill and overfill prevention devices have been installed) the tank
needs to be tightness tested annually. lf the UST is upgraded the tank ne€ds to be tested every five years. lnventory records must be kept for
each operating day.
Record of last Tank Tightness Test available on-site es No Yes No Yes No Yes
\,No
Date of last Tank Tightness Test 3lts lq a-_>
FailPass PassPass FailResult of last Tank Tightness Test. lf fail, specify in comments section what
actions have been taken to correct the problem. Has DERR been notified?
Fail Fail
=>
Type / Brand of test equipment used: fufi U/t&.ituaL
Name and company of tank tightness tester: ]-f t E n't J+c l"t..tr*h Tester Certification lumber: UT
Documentation of performance claims for the Tank Tightn€ss Test method is available and shows the ability to detect leaks
O.1 gph with 95% or greater probability of detection and 5% or less probability of false alarm (3rd party certification)
lnventory volume measurements for regulated substance inputs, withdrawals,
and the amount still remaining in the tank are recorded each operating day
No Yes@Yes No
)No
llx::f}:::::::::i':::::::
NoNo
6
:::::::::::::::::j::::l:it
Yes
lnventory is reconciled monthly (sum of daily over and short for each month
is compared to 1 % of tank's flow through volume + 130 gallons)
No@ Yes No Yes No Yes No
Which months exceed the allowable over-shortT (specify month and yea4$
lnventory Control records are maintained and available for the past 1 2
months for each tank l-qb
Yes No
l'hrv- lt-lb
Yes No Yes No Yes No
Records include monthly water monitoring to the nearest 1/8'Yes No Yes No Yes No Yes No
Monthly water readings are used to adjust monthly inventory balances Yes No Yes No Yes No Yes No
Yes No Yes No Yes- Appropriate calibration chart is used for converting product level
measurement to gallons and is available for review
No No>
Yes No Yes No YesDispenser pump has a current calibration sticker or appropriate
documentation
No No->
A drop tube is present and it extends to within one foot of tank bottom
Owner/operator can explain inventory control methods and demonstrate acceptable gauging techniques
es Yes No
No
The volume of product in the tank is measured using a:(Gauge Stick ATG
-lf a gauge stick is used, it is long enough to reach the bottom of the tank es 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 the full range of the tank's internal height
No
t^qComments
I
b
3 qM,4zr1 -7
-b qb
Signature of Owner or Owner's Representative Present During I
lnspector's Sig
v..Distribution: White-DERR,
TmL 2T!.lk I 5 nbsl fr-ls i-Sot 1
KJ laf \'g rL:er RJ R.J-automatic Flow Rostricto. {il y68,indiclte mod6l in commgnts 66ctionl
Automatic Shut-off Ocvico {if Y6a,indiclta modcl in commsms 366tion) )
ContinuouE Alarm Systom (if y68, indiclte modol in commonts s6ction)
No@ NoG,(v*?-l.9\."1 E.
z ls lqa-__>_>
(_'AFsil( ease)6i,) ,,,( Pa6t dD &1,Rosult of lasl Lino L6!k Dotoctor porfo,mlnco tgst
Set 2 6)6i) ",No€")11,"96y)b)"Rocords of last Lin6 Tio htn$6 T€st 116 rvsilablr on-sit6
3 l5 qDat6 ol lsst Lino Tighho6s T66t
G;)G)Fsil (Palt U,,I 6""1 t ),,Rosult ol l6st Lino Tighlnos. To6t
etion Numb€r: U rNamo and comp.ny of cortiliod toste.: T:r t Enl T^L S.ltw Aarh'n Utah Terto.
Vapor Monitoring (if y6s, uae V.Monitorihg ch6cklist)
Groundwttor Monitoring (il Y.s. uso Groundwator Monhoring chocklist)
lntorstitiol Monitoring (it yes, usa lntotstitisl Monitoring chocklist)
Statistical lnvo ory Roconcilistion ISIRI lit y68, u86 SIR chocklist)
Yo6 No MY€6 No
m€thod {if yes, use otho. m€thod chscklist)
Rgcords of lsst Lino Tightnos6 Tost aro .vailablo on-6it6
Oth6r app,ov6d
vm llr,]I'iFlr
Dat6 ot lr6t Lino Tightness Test
Pa6s Fail Pa6s Fail Pa6s Fail Pass FailRosult of l6st Lino Tightness Tost
Vapor Monitoring lil y66, uss Vapor Monitoring checklist)
Groundwster Monitoring (if yes, use Groundwstor Monilorino checkli6t)
lnlersthisl Monitoring (it y6s. uso lntgrstitial Monitoring chocklisi)
Statiitic.l lnvontory Reconcilistion ISIRI (iI y6s, u6€ SIR checkli6t)
Yos No Nb I,EI!Op€rates at lo56 than atmo6phoric prossurs
Other .pprovsd msthod (il u66 othor mothod checklist)
Y66 No s1li?r M
Ygs NoSlop6 of piping will allow ALL product to drain into tank whon suction is
r6l6as6d
Ys6 No Yo6 No No""J
Yo8 NoHas only O E chock valv6, locatsd diroctly und€r pump Y6s No Yg6 I No Yos No
All .bov6 information on auction piping is VERIFIABLE, uso comments
soction b6low to docum€nt how it i5 vorifiabl€.
Y6s No Yos No Y66 No Y€6 No
.-^t.e-d -\,
Dats
Comm€nts
lnspeclor's Signatur€
Signltur6 of Own€r or Ownsr's Rspr€ssntativ€ Prss6nt Ouring lnspsction
IIIIrITI
-
I II
IIIIIIIIIIIIIIIIIIIIffiffiEEEEIITI
IIIIIIIIIIITIrITIIIIIII
I ffiffiEEGE
Distribution: Whit€-DERR, Y6llow-Pi acil
iiririfi[:lliifi#ffi IGTffii**ffisfli:tffiffi ffi*]#ffifrffi
Irifffi .ffi +}f,#ffir:*:lrituttiliit ffiill*xrlpl tffiffi
ifttffiifiH
li:ti
Rscords ot last Lino Lolk Doteclor pcrformanco lsst lro lvailablo on_sitc
Dat€ of la6t Lin6 Loak Dotoclor podotmanc6 toat
Fail
ria:iti i:i:::i !!ii:!i:iii:l
l,,til{l!$:ii,i.l
FACILITY SITE PLAT v Facility tD No. \ 06005:+
NORTH
{'d
^fl' v
b
1-.t!n
*U
6l.-z
-,\\
4s,
\)54
o
+5
o 1.)'k
o
c
0
v oS"[ tuprs r LLD
the location of any reported PID or FID readings.
Potential Receptors- lndicate distance (in feet) to the nearest:
Underground utilities Active water well _
Commercial buildings
Other
Comments
V above-named lacility on lvl\n
Ilnspecto/s Signature:
(-certify that I
yeat,
Residences
Surlace water _
c",t* .|T*OQ 3k-
/
-::i #
't T'NDERGROI,'ND STORAGE TAIVK PROGRAM
TrackineForzr
-lz(ii DaE:'.c-l,,< L
Faciiitv*t0ooosr
ADDRESS:
OWNER
for ne-UqKVes-r.ro
(drd,eoscr:)
REFUND DELETE
P
I
Ct
+ love.-
EI'-:-:D BY I]''H
oz
c
to
oz
lr.EI
'-\' ' .1
i .t*
;,:., -t;_i t: 'H3i:- :'..'-i'i
;' :-:l:tsi- ''.!
!:. -+
&..8L
+.:
:3
.: .-{4dr. - r' r-i-.i' . . .r+s:5i-i..:+t:-+:;
.-r
!
t.-
.{'
4....
ri-E -l=
=- 1f
,,i
.i -:Jiz:_--:: -.F.- 5i.ii:. -.:t#l;i
=Ii
L:S i:, .t:1;t t::H'
$+tl-$3 F,, ffisffii
?,:
S,''fi
a' *)
+{dil. {1 E*.t
*.
*,tc;=
i'
-- -Bi
!*trt--F+,i[-.
--.+t&.i4*44,4!l -:'.*,;iis:i-I*l:+s-i*::t
i' . '
- .- I I .{-+- --
.;
)
ffi