S06-36C25224Q0509 0001.docx

DOCX document 5 MB Posted Aug 6, 2024

Attached to: Amendment 0001--RFQ: Fuel Storage Tanks-Inspection/Testing/Cleaning Services Federal contract opportunity
Solicitation number: 36C25224Q0509_0001
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 12

About this file

Written by GovTribe AI · Aug 6, 2024

This document is a solicitation amendment for a Request for Quote (RFQ) for Fuel Storage Tanks-Inspection/Testing/Cleaning Services. The amendment addresses vendor questions with answers from the contracting office. Key details include:

The solicitation number is 36C25224Q0509. The contracting agency is the Department of Veterans Affairs, Veterans Health Administration, Veterans Integrated Service Network 12. The solicitation is for inspection, testing, and cleaning services for various fuel storage tanks (diesel, gasoline, E-85) located at the Danville VA Medical Center. Tank sizes range from 300 to 15,000 gallons. The original quote due date is not extended. Vendors should refer to the original solicitation for submission requirements and the quote due date.

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5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

36C252 Department of Veterans Affairs

GLAC (69D)

115 South 84th Street, Suite 101

Milwaukee WI 53214-1476

36C252 Department of Veterans Affairs

GLAC-MILWAUKEE (69D)

Great Lakes Acquisition Center - HC 115 South 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25224Q0509 07-24-2024

See CONTINUATION Page one This amendment addresses vendor questions with answers from the contracting office.

The original due date of the solicitation is not extended.

Please see solicitation 36C25224Q0509 for the quote due date as well as to view submission requirements.

See continuation pages.

Sands, Scott Contracting Officer

Vendor Questions & Answers Q: What are the tank contents? Please be specific.

A: Bldg. 14 diesel AST 650-gal tank, Bldg. 98 diesel UST 4,000-gal tank, Bldg. 58 diesel 8,550-gal AST tank, Bldg. 104 diesel 8,000-gal UST tank, Bldg. 128/129 diesel 300-gal AST tank, Bldg. 130 diesel 375-gal AST tank, Bldg. 131 diesel 375-gal AST tank, Bldg. 132/133 diesel 1,400-gal AST tank, Bldg. 140 diesel 1,495-gal AST tank, Bldg. 211 diesel 15,000-gal UST tank, Bldg. 212 diesel 10,00-gal UST tank, Bldg. 214 diesel 6,000-gal UST tank, Bldg. 216 diesel 6,000-gal UST tank, GSA lot diesel 5,000-gal UST tank Gas 4,000-gal UST E-85 4,000-gal UST Q: What are the tank sizes in height and diameter?

A: We have no exact dimensions to the USTs, ASTs but exact gallon sizes are listed above.

Q: What is the size of the manway on the top of the tanks?

A: No manways on the tanks.

Q: Are you wanting the SP001/API-653 internal and/or external portion of the tank inspected?

A: Yes, on the AST’s

Q: Do you have any previous inspection reports of the tanks? If so, can they be shared for viewing?

A: See files below-

Q: Are blueprints of the tanks available? If so, can they be shared for viewing?

A: No, they are not available.

Q: Is there a current contract for the work being solicited? If so, please provide that awarded contract number or task order number.

A: Previous contract # 36C25220C0003 can be found at FPDS (https://www.fpds.gov/).

Q: When was the last time the tanks and fuel were filtered and tested?

A: April 2023 Q: Can a copy of the most recent lab reports on the fuel be provided?

A: See files previously listed.

Q: Line Items 0005, 1005, 2004, 3004, 4005 requests pricing for: “Additional cost to remove sediment, water, sludge over 1" per tank on fourteen (14) UST and AST with COR verification in accordance with the SOW.” I do not see anything regarding sludge over 1” in the SOW. Are you aware of excessive sludge in any of the tanks? Please explain this line item.

A: This has been added to allow for cleaning above and beyond normal cleaning but has never been a factor.

Q: What company has performed previous UST testing services for this location?

A: Information regarding previous contract # 36C25220C0003 can be found at FPDS (https://www.fpds.gov/).

Amendment 0001-Vendor Questions & Answers to Solicitation # 36C25224Q0509 3-4-2854328_XN (2).pdf

- 1 -

ĆUSTOMER: CLEAN FUELS NATIONAL

PLANT: DANVILLE VA

FUEL BLDG 214

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:37:05

SAMPLE NO: 3641-61-3-4

PO NUMBER: 60263

Spec Compliance

COMPLIANT

NOTE

• All limits derived from ASTM/CGSB specifications

Date(DD/MM/YY) 01-11-22 SPEC.

Labno 2854328

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.43 1.9-4.1

WATER KARL FISHER (%) 0.005 0.02 MAX

FLASH POINT CLOSED CUP [ASTM D93] 63 125.6 °F MIN

DENSITY [ASTM D4052] 0.818 REPORT

DISTILLATION

Initial Boiling Point (°F) 351 - 10% Recovered (°F) 399 - 50% Recovered (°F) 490 510.8 TYPICAL 90% Recovered (°F) 595 539.6-640.4 Final Boiling Point (°F) - Total Recovered (°F) - Residue (%) -

API GRAVITY [ASTM D287] 41.55 34-38 TYPICAL

SULFUR in ppm 12 15 MAX

CETANE INDEX 67 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -9 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.200 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

CARBON RESIDUE - 0.35 MAX

PARTICLE COUNT

>4 589 2500 MAX

>6 97 640 MAX

>14 30 80 MAX

>25 6 - >50 0 - >100 0 -

ISO 4406 16/ 14/ 12 18/16/13

BLDG 214

(SP) SPECTROSCOPIC ANALYSIS [ASTM D5185] (elements seen in ppm) TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

* elements below detection limit are not displayed on table Date(MM/DD/YY) 11-01-22 09-10-21 08-25-21 06-23-21 (n/a) (n/a) (n/a) (n/a) REF

Labno 2854328 2752051 2747504 2731116 Si-SILICON 1.0 - Mg-MAGNESIUM 1.0 - Na-SODIUM 2.0 -

P-PHOSPHORUS 4.0 -

CLEAN FUELS NATIONAL assumes sole responsibility for the total copy, reproduction, application of and reliance upon results and recommendations reported by Tribologik Corporation, whose obligation is limited to good faith performance. Fixed limits programmed according to laboratory or client specifications. Report indicates tests performed only and are approved and released under the authority of chemist number 1026.

BLDG 214

image3.emf

1-4-2854327_XC.pdf

FUEL BLDG 98

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:36:54

SAMPLE NO: 3641-61-1-4

NON-COMPLIANT

• Recommend to contact tank cleaning/maintenance firm as soon as possible.

• Particle Count is outside of specifed limit.

• Particles can be removed through tank filtration and cleaning

BLDG 98

Labno 2854327

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.52 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 131 125.6 °F MIN

DENSITY [ASTM D4052] 0.830 REPORT

Initial Boiling Point (°F) 325 - 10% Recovered (°F) 380 - 50% Recovered (°F) 473 510.8 TYPICAL 90% Recovered (°F) 592 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 38.90 34-38 TYPICAL

SULFUR in ppm 8 15 MAX

CETANE INDEX 64 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -12 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.200 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 6319 2500 MAX

>6 548 640 MAX

>14 3 80 MAX

>25 0 - >50 0 -

ISO 4406 20/ 16/ 9 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Labno 2854327 2752053 2747507 2731108

P-PHOSPHORUS 1.0 -

image4.emf

7-2-2854324_XN (1).pdf

FUEL BLDG 130

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:36:16

SAMPLE NO: 3641-61-7-2

PO NUMBER: 60262

Labno 2854324

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.79 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 145 125.6 °F MIN

DENSITY [ASTM D4052] 0.847 REPORT

Initial Boiling Point (°F) 370 - 10% Recovered (°F) 390 - 50% Recovered (°F) 486 510.8 TYPICAL 90% Recovered (°F) 600 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 35.56 34-38 TYPICAL

SULFUR in ppm 14 15 MAX

CETANE INDEX 57 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -11 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.000 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 123 2500 MAX

>6 36 640 MAX

>14 10 80 MAX

>25 0 - >50 0 -

ISO 4406 14/ 12/ 10 18/16/13

BLDG 130

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 06-23-21 (n/a) (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854324 2731131

P-PHOSPHORUS 3.0 -

BLDG 130

image5.emf

5-2-2854323_XN (1).pdf

FUEL BLDG 131 AST

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:36:05

SAMPLE NO: 3641-61-5-2

Labno 2854323

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.74 1.9-4.1

WATER KARL FISHER (%) 0.006 0.02 MAX

FLASH POINT CLOSED CUP [ASTM D93] 143 125.6 °F MIN

DENSITY [ASTM D4052] 0.844 REPORT

Initial Boiling Point (°F) 347 - 10% Recovered (°F) 405 - 50% Recovered (°F) 496 510.8 TYPICAL 90% Recovered (°F) 603 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 36.17 34-38 TYPICAL

SULFUR in ppm 13 15 MAX

CETANE INDEX 57 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -12 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.700 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 191 2500 MAX

>6 51 640 MAX

>14 13 80 MAX

>25 0 - >50 0 -

ISO 4406 15/ 13/ 11 18/16/13

BLDG 131 AST

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 06-23-21 (n/a) (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854323 2731129

Mg-MAGNESIUM 2.0 - Na-SODIUM 2.0 - Ca-CALCIUM 1.0 -

BLDG 131 AST

image6.emf

8-3-2854331_XN.pdf

FUEL BLDG 216 UST

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:37:43

SAMPLE NO: 3641-61-8-3

Labno 2854331

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.87 1.9-4.1

WATER KARL FISHER (%) 0.007 0.02 MAX

FLASH POINT CLOSED CUP [ASTM D93] 61 125.6 °F MIN

DENSITY [ASTM D4052] 0.822 REPORT

Initial Boiling Point (°F) 336 -

50% Recovered (°F) 496 510.8 TYPICAL 90% Recovered (°F) 596 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 40.75 34-38 TYPICAL

SULFUR in ppm 15 15 MAX

CETANE INDEX 65 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -13 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.800 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 485 2500 MAX

>6 205 640 MAX

>14 33 80 MAX

>25 3 - >50 3 -

ISO 4406 16/ 15/ 12 18/16/13

BLDG 216 UST

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 09-10-21 06-23-21 (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854331 2752055 2731132

BLDG 216 UST

image7.emf

9-4-2854332_XN.pdf

FUEL BLDG 211 UST

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:37:58

SAMPLE NO: 3641-61-9-4

Labno 2854332

VISCOSITY /40 [ASTM D445] in cSt 40°C 3.05 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 62 125.6 °F MIN

DENSITY [ASTM D4052] 0.833 REPORT

Initial Boiling Point (°F) 359 -

50% Recovered (°F) 489 510.8 TYPICAL 90% Recovered (°F) 590 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 38.37 34-38 TYPICAL

SULFUR in ppm 13 15 MAX

CETANE INDEX 61 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -10 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.600 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 740 2500 MAX

>6 218 640 MAX

>14 17 80 MAX

>25 3 - >50 0 -

ISO 4406 17/ 15/ 11 18/16/13

BLDG 211 UST

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Labno 2854332 2752052 2747506 2731123

BLDG 211 UST

image8.emf

20-3-2854333_XC.pdf

FUEL BLDG 104

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:38:09

SAMPLE NO: 3641-61-20-3

• Sulfur is outside specified limit.

• Sulfur content should be discussed with diesel fuel supplier.

BLDG 104

Labno 2854333

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.79 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 140 125.6 °F MIN

DENSITY [ASTM D4052] 0.836 REPORT

Initial Boiling Point (°F) 338 - 10% Recovered (°F) 407 - 50% Recovered (°F) 496 510.8 TYPICAL 90% Recovered (°F) 598 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 37.82 34-38 TYPICAL

SULFUR in ppm 18 15 MAX

CETANE INDEX 60 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -12 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.800 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 434 2500 MAX

>6 119 640 MAX

>14 27 80 MAX

>25 3 - >50 0 -

ISO 4406 16/ 14/ 12 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 07-01-21 07-01-21 (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854333 2733177 2733176 Sn-TIN - 3.0 - Si-SILICON 1.0 - - Ca-CALCIUM - 1.0 -

P-PHOSPHORUS 2.0 2.0 -

BLDG 104

image9.emf

10-3-2854325_XC.pdf

FUEL BLDG 14

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:36:28

SAMPLE NO: 3641-61-10-3

• All limits derived from ASTM/CGSB specifications.

• Sulfur and Par ticle Count are outside of specifed limit.

• Sulfur content should be discussed with diesel fuel supplier

• Particulate can be removed through tank filtration and cleaning.

BLDG 14

Labno 2854325

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.74 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 147 125.6 °F MIN

Initial Boiling Point (°F) 356 - 10% Recovered (°F) 405 - 50% Recovered (°F) 492 510.8 TYPICAL 90% Recovered (°F) 595 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 37.82 34-38 TYPICAL

SULFUR in ppm 26 15 MAX

CETANE INDEX 60 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -12 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.800 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 45921 2500 MAX

>6 12311 640 MAX

>14 93 80 MAX

>25 3 - >50 0 -

ISO 4406 23/ 21/ 14 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 08-25-21 06-23-21 (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854325 2747505 2731134

P-PHOSPHORUS 2.0 -

image10.emf

2023.01.26 - BLDG_14_4 (2).pdf

FUEL BLDG 14

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 19-JAN-23

CONTACT 1: LACIE SAUER

REPORT: 24-JAN-23 16:23:39

SAMPLE NO: 3641-61-10-4

PO NUMBER: 60422

• All limits derived from ASTM/ CGSB specifications.

• Particle count is outside specified limit.

Date(DD/MM/YY) 17-01-23 SPEC.

Labno 2872635

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.66 1.9-4.1

WATER KARL FISHER (%) 0.004 0.02 MAX

FLASH POINT CLOSED CUP [ASTM D93] 158 125.6 °F MIN

Initial Boiling Point (°F) 348 - 10% Recovered (°F) 391 - 50% Recovered (°F) 493 510.8 TYPICAL 90% Recovered (°F) 606 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 38.43 34-38 TYPICAL

SULFUR in ppm 12 15 MAX

CETANE INDEX 61 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -12 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 0.000 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 6484 2500 MAX

>6 2497 640 MAX

>14 260 80 MAX

>25 30 - >50 0 -

ISO 4406 20/ 18/ 15 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 01-17-23 11-01-22 08-25-21 06-23-21 (n/a) (n/a) (n/a) (n/a) REF

Labno 2872635 2854325 2747505 2731134 Si-SILICON 1.0 1.0 -

P-PHOSPHORUS - 2.0 -

Zn-ZINC 1.0 - -

image11.emf

24-1-2854326_XN (2).pdf

FUEL BLDG 128

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 02-NOV-22

CONTACT 1: LACIE SAUER

REPORT: 09-NOV-22 13:36:41

SAMPLE NO: 3641-61-24-1

Labno 2854326

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.61 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 66 125.6 °F MIN

Initial Boiling Point (°F) 370 - 10% Recovered (°F) 403 - 50% Recovered (°F) 484 510.8 TYPICAL 90% Recovered (°F) 589 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 37.80 34-38 TYPICAL

CETANE INDEX 61 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -11 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.400 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 1430 2500 MAX

>6 126 640 MAX

>14 10 80 MAX

>25 0 - >50 0 -

ISO 4406 18/ 14/ 10 18/16/13

BLDG 128

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 11-01-22 (n/a) (n/a) (n/a) (n/a) (n/a) (n/a) (n/a) REF

Labno 2854326

BLDG 128

image12.emf

2023.01.26 - BLDG_58_4 (1).pdf

FUEL BLDG 58

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 19-JAN-23

CONTACT 1: LACIE SAUER

REPORT: 24-JAN-23 16:22:01

SAMPLE NO: 3641-61-6-4

BLDG 58

Labno 2872634

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.30 1.9-4.1

WATER KARL FISHER (%) 0.007 0.02 MAX

FLASH POINT CLOSED CUP [ASTM D93] 140 125.6 °F MIN

DENSITY [ASTM D4052] 0.834 REPORT

Initial Boiling Point (°F) 334 - 10% Recovered (°F) 374 - 50% Recovered (°F) 474 510.8 TYPICAL 90% Recovered (°F) 579 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 38.21 34-38 TYPICAL

CETANE INDEX 62 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -22 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 1.200 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 8677 2500 MAX

>6 1332 640 MAX

>14 87 80 MAX

>25 20 - >50 0 -

ISO 4406 20/ 18/ 14 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 01-17-23 11-01-22 08-25-21 06-23-21 (n/a) (n/a) (n/a) (n/a) REF

Labno 2872634 2854330 2747508 2731119 Sn-TIN 1.0 - - Si-SILICON - 1.0 -

P-PHOSPHORUS - 2.0 -

BLDG 58

image13.emf

2023.01.26 - BLDG_98_5 (1).pdf

FUEL BLDG 98

LOCATION

FUEL TYPE: ULS #2 DIESEL FUEL

MANUFACTURER: Missing information

RECEIVED: 19-JAN-23

CONTACT 1: LACIE SAUER

REPORT: 24-JAN-23 16:21:51

SAMPLE NO: 3641-61-1-5

Labno 2872633

VISCOSITY /40 [ASTM D445] in cSt 40°C 2.32 1.9-4.1

FLASH POINT CLOSED CUP [ASTM D93] 136 125.6 °F MIN

Initial Boiling Point (°F) 324 - 10% Recovered (°F) 388 - 50% Recovered (°F) 479 510.8 TYPICAL 90% Recovered (°F) 602 539.6-640.4 Final Boiling Point (°F) -

API GRAVITY [ASTM D287] 38.41 34-38 TYPICAL

CETANE INDEX 62 40 MIN

POUR POINT [ASTM D97] , °F - REPORT

CLOUD POINT [ASTM D2500] , °F -18 REPORT

COPPER CORROSION [ASTM D130] - 3

ASH (%) [ASTM D482] - 0.01 MAX

WATER AND SEDIMENT (%) [ASTM D2709] - 0.05 MAX

TOTAL BACTERIA/MOLD KIT TEST 0 0 MAX

BIODIESEL CONTENT (%) 0.000 5.000 MAX

CETANE NUMBER [D 613] - 40 MIN

OXIDATION STABILITY [ASTM D7545] - REPORT

>4 12077 2500 MAX

>6 2320 640 MAX

>14 154 80 MAX

>25 23 - >50 0 -

ISO 4406 21/ 18/ 14 18/16/13

TESTED ELEMENTS ARE: Fe, Cu, Pb, Sn, Cr, Al, Ni, Ti, Ag, V, Mg, Si, B, Na, Ba, Ca, P, Mn, Zn, Mo, Cd, K *

Date(MM/DD/YY) 01-17-23 11-01-22 09-10-21 08-25-21 06-23-21 (n/a) (n/a) (n/a) REF

Labno 2872633 2854327 2752053 2747507 2731108 Si-SILICON - 1.0 -

P-PHOSPHORUS 1.0 1.0 -

image14.emf

23DanvilleVAMedicalCenter Annual.pdf

Annual Compliance Testing Report

Customer & Location Info Customer Location Address City, State Zip Code Contact Info Date OSFM Green Tag Date

Facility ID# Annual Testing Due Date

The enclosed reports are the result of the Compliance testing completed at the above location.

1. A report to be posted at the job site to give to the State Fire Marshal during his inspection.

2. A checklist showing the items inspected and the results from that inspection.

Tank/Line System info Tank System

ID #

Product Stored

Notes:

Precision Line Testing Results Line ID Type Results

Leak Detection Results

Type

ATG Certification Make of Tank Monitor Model of Tank Monitor Tank ID

Sensor Test Results Sensor ID Type

Technician performing inspection: Bob Kath ICC Certification #9126471

Please note the following maintenance needs to be completed:

Thank you for the opportunity to be of service. Please contact me if you have any questions.

PHONE: (309) 347-1819 EMAIL: compliance@iome.com

Respectfully submitted, Zak Paxton Compliance Department

Customer Danville VA Medical Center Location Building 98 Address 1900 East Main Street City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov Date 10/27/2022 OSFM Green Tag Date 2024 Facility ID# 11148 Triennial Testing Date 08/02/2022 Due 08/02/2025

Annual Compliance Testing Tank & Line ID (15) 4,000

Product Diesel

Tank/Line ID N/A

Notes: European Suction.

Tank/Line ID 15 15

Product Diesel Diesel Type Sump Sensor Tank Sensor

Results Passed Passed

Make of Tank Monitor Veeder Root Model of Tank Monitor TLS-350 with CSLD

Tank ID 15

Results Passed

Notes: 1 Probe and 2 Sensors.

Technician Name John (Bob) Kath Certification # d9b1c40d

Signature

Triennial Compliance Testing Report

Triennial STP Containment Sump Testing (3 Year Testing) Sump ID 15

Date 08/02/2022

Triennial Spill Container Containment Testing (3 Year Testing) Sump ID 15

Notes: Double Walled.

Triennial Dispenser Containment Sump Testing (3 Year Testing) Sump ID N/A

Date

Triennial Overfill Prevention Testing (3 Year Testing) Tank ID 15

Notes: 1 Ball float.

Compliance@iome.com

Customer Danville VA Medical Center Location Building 104

City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (17) 8,000

Line Leak Detection Results Tank/Line ID 17 17 17

Product Diesel Diesel Diesel Type Sump Sensor Sump Sensor Tank Sensor

Results Passed Passed Passed

Make of Tank Monitor Veeder Root Model of Tank Monitor TLS-350 with CSLD

Tank ID 17

Notes: 1 Probe and 3 Sensors.

Sump ID 17

Tank ID 17

Notes: 1 Overfill Valve.

Customer Danville VA Medical Center Location Building 211

City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (30) 15,000

Tank/Line ID 30 30 30

Make of Tank Monitor INCON Model of Tank Monitor TS-550

Tank ID 30

Sump ID 30 30

Date 08/02/2022 08/02/2022

Sump ID 30

Tank ID 30 Valve

Notes: 1 Valve and 1 Alarm.

Customer Danville VA Medical Center Location Building 212

City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (31) 10,000

Tank/Line ID

Notes: European Suction Piping.

Tank/Line ID 31 31 31

Tank ID 31

Sump ID 31

Tank ID 31

Notes: 1 Overfill Valve.

Customer Danville VA Medical Center Location Building 214 Address 1900 East Main Street City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (32) 6,000

Tank/Line ID 32 32 32

Tank ID 32

Sump ID 32 32

Sump ID 32

Tank ID 32

Notes: 1 Overfill Valve and 1 Overfill Alarm.

Customer Danville VA Medical Center Location Building 216 Address 1900 East Main Street City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (33) 6,000

Tank/Line ID 33 33 33

Tank ID 33

Results FAILED

Notes: 1 Probe and 3 Sensors. Probe is Bad and needs to be replaced.

Sump ID 33 33

Sump ID 33

Tank ID 33

Notes: 1 Overfill Valve 1 Alarm.

Customer Danville VA Medical Center Location GSA Lot Address 1900 East Main Street City, State Zip Code Danville, IL 61832 Contact Info Michael Miller 765-585-5466 E-mail Michael.miller16@va.gov

Tank & Line ID (34) 4,000 (35) 4,000 (36) 5,000

Product Diesel Gasoline E-85

Tank/Line ID N/A N/A N/A

Tank/Line ID 34 34 35 35 36 36

Product Diesel Diesel Gasoline Gasoline E-85 E-85 Type 2 Sump Sensors Tank Sensor 2 Sump Sensors Tank sensor 2 Sump Sensors Tank Sensor

Results Passed Passed Passed Passed Passed Passed

Make of Tank Monitor Veedet Root Model of Tank Monitor TLS-350 with CSLD

Tank ID 34 35 36

Notes: 3 Probes and 9 Sensors. 4 E Stops.

Sump ID 34 35 36

Date 08/02/2022 08/2/2022 08/02/2022

Tank ID 34 35 36

Notes: 3 Drop Tube Overfill Valves.

Customer Location Address City, State Zip Code Contact Info Date OSFM Green Tag Date

Facility ID# Annual Testing Due Date

Tank/Line System info Tank System

ID #

Stored

Type

Make of Tank Monitor Model of Tank Monitor Tank ID

Sensor Test Results

Technician performing inspection: Bob Kath ICC Certification #9126471

Please note the following maintenance needs to be completed:

PHONE: (309) 347-1819 EMAIL: compliance@iome.com

Facility #: 4016258

Facility Address: 1900 East Main Street, Danville, IL 61832

Annual Walkthrough Inspection Report: 2022 (year)

Inspections Required Annually (Inspections of piping sump areas must be performed by a certified employee of a contractor licensed in either the Install/Retrofit or Tank Tightness Testing modules.) All piping sumps areas shall be checked annually. Sump lids must be lifted and dispenser cabinets opened to inspect piping containment sump areas.

Contractor must initial and enter date of Annual Walkthrough Inspection.

Day/Month/Year of Inspection

Contractor Initials

Enter comments below corresponding to inspections listed at left.

Visual check for damage to piping containment sump areas: Check lids, covers & containment for damage & leaks.

10/27/2022 JK COMMENTS & ACTIONS TAKEN:

Check sumps for the presence of regulated substances or any indication that a release may have occurred. Remove any liquid or debris if present.

Check that interstices of double wall containment sumps are free of water or product.

DW on 4 newer spill buckets.

If applicable: Check gauge stick (manual tank gauging) or bailer (GW monitoring).

Contractor Employee Conducting Annual Inspection of Piping Containment Sump Areas:

1) Signature:

2) Print Name & Title: John R Kath Compliance Technician

Annual Test & Inspection: May be Performed by Contractor or A/B Operator Contractor or A/B Operator must initial and enter date of Annual Emergency Stops Test.

Day/Month/Year of Emergency Stop Test

10/27/2022

Operator Initials

Enter comments below regarding Annual Emergency Stops Test. Attach OSFM Operational Testing of Emergency Stops Report to Walkthrough Inspection Report & keep at facility.

Test Emergency Stops for interconnection and STP shutdown.

Attach OSFM report form.

COMMENTS:

Tested 4 Switches (GSA Lot.)

Operator must initial and enter date of Annual Shear Valve Inspection.

Shear Valve Inspection

Enter comments below regarding Annual Shear Valve Inspection. Attach OSFM Annual Inspection of Shear Valves Report to Walkthrough Inspection Report & keep at facility.

Check shear valves for proper height, secure mounting & free operation of trip arm & poppet.

3 Shear points under Euro Suction dispenser Pumps. (GSA Lot.)

A/B Operator Signature (if applicable):

Print Name of A/B Operator (if applicable):

4016258

Veterans Administration Medical Center

1900 East Main Street

Danville IL 61832

Danville Vermilion

4 (1 main & 3 wireless)

John R Kath

10/26/2023

State of Illinois Office of the State Fire Marshal

Certification of Annual Inspection of All Dispenser Shear Valves

KEEP FORM AT FACILITY

DO NOT MAIL OR FAX TO OSFM

(217) 785-1020 or (217) 785-5878

(1) OWNER OF TANKS: (2) FACILITY - name and address where tanks are located:

Name: Veterans Administration Medical Center Name: Veterans Administration Medical Center

Street Address: 1900 East Main Street Street Address: 1900 East Main Street

City: Danville State: IL Zip: 61832 City: Danville County: Vermillion

Contact Name: Contact Name:

Phone #: Fax #: Phone #: Fax #:

The regulations of the Office of the State Fire Marshal ("OSFM") in Sections 175.210, 175.220, 175.230, 175.240 and 175.250 require that facilities dispensing motor fuels, such as attended and unattended self-service stations, full-service stations, fleet facilities and marinas, perform visual inspections of all under-dispenser shear valves at least annually.

The following criteria shall be used when inspecting the shear valves:

1) All shear valves shall be mounted using a listed rigid anchor.

2) All shear valves shall be mounted securely to the listed rigid anchor.

3) All shear valves shall be mounted at the proper height relative to grade following the shear valve manufacturer's installation instructions.

4) All shear valves shall be maintained in proper working condition.

5) In addition, the dispensers themselves will also be inspected when the shear valves are checked to confirm that each dispenser is properly and securely mounted to its island.

It is the duty of OSFM to make sure that these shear valves have all been inspected and found to be properly mounted, which is critical to their operation as a fuel shut-off safety device. The shear valves must also be verified as having been maintained in proper working condition, including having the fusible link correctly holding the valve arm, to ensure closure of the poppet valves when released upon a dispenser being damaged or a fire melting the link.

OSFM inspectors will confirm that all shear valves comply with the above requirements during an inspection. The OSFM inspectors will also check for documentation showing that a visual inspection of all shear valves has been performed annually.

This form, filled out and signed, can provide such documentation.

Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he/she verily believes the same to be true.

By signing this document, I certify that I personally inspected the shear valves at the facility identified above by its OSFM Facility Number. I confirmed that all shear valves are properly secured and mounted correctly, that there are shear valves present on each dispensing device, and that all shear valves are in proper working order with fusible links and arms engaged.

Euro suction 3 Shear Points 10/26/2023

(Number of Shear Valves Inspected) (Date of Test)

(Name of Tester) (Signature of Tester)

DPCS - Shear Valve Report (4/15)

OFFICE OF THE ILLINOIS STATE FIRE MARSHAL

Annual Leak Detection Certification Test Form

Contractor Name Illinois Oil Marketing Equipment, Inc.

Address 850 Brenkman Drive Pekin, IL 61554

Phone Number (309) 347-1819

Licensed Contractor - IL1293

Facility Name Veterans Administration Medical Center

Address 1900 East Main Street, Bldg.

#14

Danville, IL 61832 County Vermilion

Contact Person Michael M.

Phone Number (217) 554-5994

Facility - 4016258

Test Results Per 175.610(a)(4), a test of the proper operation of leak detection systems and components must be performed at installation of the equipment and at least annually thereafter and, at a minimum, as applicable to the facility, shall cover the following components and criteria:

Tank 15 - 4,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump Sensor

Probes and Sensors:

1. Does the sensor activate with a float mechanism Pass Fail N/A

2. Cables are Free of Kinks Pass Fail

3. Alarm Operates Pass Fail

4. Alarm Communicates with Controller Pass Fail Stand Alone

5. Floats Move Freely Pass Fail

6. Shaft not Damaged or Bent Pass Fail

Vacuum Pumps & Pressure Gauges:

1. Proper Communication with Sensors Pass Fail N/A

2. Proper Communication with Controller Pass Fail N/A

Test Date 10/26/2023

Tank 15 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS 350 Plus with CSLD

Automatic Tank Gauge and other controllers:

1. Test Alarm Pass Fail

2. Verify System Configuration Pass Fail

3. Test Battery Backup Pass Fail N/A

4. Verify positive shutdown (Mandatory for systems installed after 9/1/2010 or if using low level containment test option) Pass Fail N/A

PDF Generated: 11/7/2023 9:00:24 AM Page 1 of 12

Tank 15 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Hydrostatic Reservoir Interstitial Monitoring Sensors

Tank 16 - 4,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

1. Does the sensor activate with a float mechanism ***Failed Test*** Pass Fail N/A

2. Cables are Free of Kinks ***Failed Test*** Pass Fail

3. Alarm Operates ***Failed Test*** Pass Fail

4. Alarm Communicates with Controller ***Failed Test*** Pass Fail Stand Alone

5. Sensor tested per manufacture instructions ***Failed Test*** Pass Fail

Test Comments Veeder Root ATG consul was found to have been removed for site renovations. Sensors and probe are inoperable without

ATG.

Tank 16 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS 350 Plus

1. Test Alarm ***Failed Test*** Pass Fail

2. Verify System Configuration ***Failed Test*** Pass Fail

3. Test Battery Backup ***Failed Test*** Pass Fail N/A

Veeder Root ATG consul was found to have been removed for site renovations. Sensors and probe are inoperable without

PDF Generated: 11/7/2023 9:00:24 AM Page 2 of 12

Tank 16 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Hydrostatic Reservoir Interstitial Monitoring Sensors

Veeder Root ATG consul was found to have been removed for site renovations. Sensors and probe are inoperable without

Tank 17 - 8,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

Tank 17 - 8,000 gallons - Diesel Fuel - Piping - Single Wall Transition Sump - Leak Detect - Piping - Sump

PDF Generated: 11/7/2023 9:00:24 AM Page 3 of 12

Tank 17 - 8,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS 350 Plus

Tank 17 - 8,000 gallons - Diesel Fuel - Leak Detect - Tank - Hydrostatic Reservoir Interstitial Monitoring Sensors

Tank 30 - 15,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

PDF Generated: 11/7/2023 9:00:24 AM Page 4 of 12

Tank 30 - 15,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Incon TS 550

Tank 30 - 15,000 gallons - Diesel Fuel - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 31 - 10,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

PDF Generated: 11/7/2023 9:00:24 AM Page 5 of 12

Tank 31 - 10,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Incon TS 550

Tank 31 - 10,000 gallons - Diesel Fuel - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 32 - 6,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

PDF Generated: 11/7/2023 9:00:24 AM Page 6 of 12

Tank 32 - 6,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Incon TS 550

1. Test Alarm ***Failed Test*** Pass Fail

2. Verify System Configuration ***Failed Test*** Pass Fail

3. Test Battery Backup ***Failed Test*** Pass Fail N/A

Probe is bad and not communicating with ATG.

Tank 32 - 6,000 gallons - Diesel Fuel - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 33 - 6,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

PDF Generated: 11/7/2023 9:00:24 AM Page 7 of 12

Tank 33 - 6,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Incon TS 550

Tank 33 - 6,000 gallons - Diesel Fuel - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 34 - 4,000 gallons - Diesel Fuel - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump

PDF Generated: 11/7/2023 9:00:24 AM Page 8 of 12

Tank 34 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS 350

Tank 34 - 4,000 gallons - Diesel Fuel - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 35 - 4,000 gallons - Gasoline - Regular - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

PDF Generated: 11/7/2023 9:00:24 AM Page 9 of 12

Tank 35 - 4,000 gallons - Gasoline - Regular - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS

Tank 35 - 4,000 gallons - Gasoline - Regular - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Tank 36 - 5,000 gallons - E85 - Piping - Single Wall STP/Tanktop Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

PDF Generated: 11/7/2023 9:00:24 AM Page 10 of 12

Tank 36 - 5,000 gallons - E85 - Leak Detect - Tank - Automatic Tank Gauging Veeder Root TLS 350

Tank 36 - 5,000 gallons - E85 - Leak Detect - Tank - Non-Discriminating Interstitial Monitoring Sensors

Dispenser Diesel - Dispenser - Single Wall UDC Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

PDF Generated: 11/7/2023 9:00:24 AM Page 11 of 12

Dispenser Gasoline - Dispenser - Single Wall UDC Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

Dispenser E85 - Dispenser - Single Wall UDC Sump - Leak Detect - Piping - Sump Sensor with positive shutdown

Date Description File

Contractor Employee Conducting Test Employee Name Kath, John Robert Title Compliance Tech

Terms And Conditions Under the penalties as provided by law pursuant to Section 1-109 of the Code of Civil Procedure, the undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters stated to be on information and belief and as to such matters the undersigned certifies as aforesaid that he/she verily believes the same to be true.

By checking this box, I certify that the Annual Leak Detection Certification Report Form has been completed as required by OSFM rules.

Submitter Name John Kath

Email compliance@iome.com

PDF Generated: 11/7/2023 9:00:24 AM Page 12 of 12

Contractor Name Illinois Oil Marketing Equipment, Inc.

NOV - E0020231103

Nov Type NOV Status Pending

Nov Date 5/3/2023 Expiration Date 7/2/2023

Owner / Operator Veterans Administration Medical Center

Facility

Address

1900 East Main Street, Bldg. #14

NOV Extension Form

NOV Information

Reason We are asking for a 90 extension to complete quoting process, permit process and repairs to be made. The plan is to remove ball float and install Overfill alarm on this tank.

Supporting Documents Contract/Quote Documents

Document Name Last Uploaded

VA Danville Overfill Alarm.pdf 06/23/2023 9:43:16

Down Payment Documents I certify that Illinois Oil Marketing Equipment, Inc. does not require a down payment to start the work required to comply with the above referenced Notice of Violation.

undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters stated to be on information and belief and as to such matters the undersigned certifies as aforesaid

By checking this box, I certify that the NOV Extension Form has been completed as required by OSFM rules.

Contact Information Submitter Name Zak Paxton

Approved EXTENSION GRANTED: Our office has received a request for an extension of the above referenced No�ce of Viola�on. If compliance is not made by 10/2/2023, your underground storage tank system could be subject to RED TAG. Tanks that are red tagged will be prohibited from having product placed into the UST system when a RED TAG exists. This case could then be forwarded to the Illinois A�orney General’s Office for prosecu�on with the possibility of fines and/or removal of the UST system.

Sincerely

Submitted Date & Time: 6/28/2023 9:01:01 AM Page 1 of 2

Scott Johnson

6/28/2023

Submitted Date & Time: 6/28/2023 9:01:01 AM Page 2 of 2

Overfill Prevention Equipment Inspection Form

Inspection Tank 15 - 4000 gallons - Diesel Fuel - * Overfill Prev Device - Overfill Alarm

Replacing via Permit 01115-2023UPG

1. Are electronic device and Probe operating properly? Yes No

2. Does alarm activate at 90% of tank capacity? Yes No

3. Can alarm be heard and seen from tank fueling area? Yes No

Result of Inspection Pass Inspection Date 09/22/2023

Inspection Results

Contractor Employee Conducting Inspection Employee Name White, Nathan Title Service Tech undersigned certifies that the statements set forth in this instrument are true and correct, except as to matters stated to be on information and belief and as to such matters the undersigned certifies as aforesaid

By checking this box, I certify that the Overfill Prevention Equipment Inspection Report Form has been completed as

Submitter Name Zak Paxton

PDF Generated: 10/4/2023 12:44:23 PM Page 1 of 1

Facility Address: 1900 East Main Street, Danville, IL 61832

Annual Walkthrough Inspection Report: 2022 (year)

Contractor must initial and enter date of Annual Walkthrough Inspection.

Day/Month/Year of Inspection

Contractor Initials

Enter comments below corresponding to inspections listed at left.

Visual check for damage to piping containment sump areas: Check lids, covers & containment for damage & leaks.

Check sumps for the presence of regulated substances or any indication that a release may have occurred. Remove any liquid or debris if present.

Check that interstices of double wall containment sumps are free of water or product.

DW on 4 newer spill buckets.

If applicable: Check gauge stick (manual tank gauging) or bailer (GW monitoring).

Contractor Employee Conducting Annual Inspection of Piping Containment Sump Areas:

1) Signature:

2) Print Name & Title: John R Kath Compliance Technician

Annual Test & Inspection: May be Performed by Contractor or A/B Operator

Operator must initial and enter date of Annual Emergency Stops Test.

Emergency Stop Test

Enter comments below regarding Annual Emergency Stops Test. Attach OSFM Operational Testing of Emergency Stops Report to Walkthrough Inspection Report & keep at facility.

Test Emergency Stops for interconnection and STP shutdown.

Attach OSFM report form.

Tested 4 Switches (GSA Lot.)

Operator must initial and enter date of Annual Shear Valve Inspection.

Shear Valve Inspection

Enter comments below regarding Annual Shear Valve Inspection.

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File details come from the government source that posted it. Updated Aug 6, 2024.