DERR-2024-004272

IMPACT VALVE
LEAK DETECTOR
MONITOR CERTIFICATION
PV VENT CAP
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 2/16/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 2/15/2024
Order Number: 2364638
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN 35470
3311 South 700 East
State ID 4000690
Salt Lake City, UT 84106
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN 35470
3311 South 700 East State ID 4000690
Salt Lake City UT 84106
35470
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
02/15/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000LD2000LD2000
30
30
110
2
20
3
30
30
110
2
20
3
UT151
David Mathie
NW1-2364638
TTNK1:1 TTNK2:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2364638 Date:2/15/2024
Site Name/ID:7-ELEVEN 35470
Address:3311 South 700 East State ID 4000690
City:Salt Lake City State:UT Zip:84106
How Inspected: Line Test NFPA 30A PEI RP1200 Other STP PRESSURE
Dispenser
Number Grade
Secure
Mount?
Valve
Lock?Pass/ Fail Comments
1/2 85 Pass Fail Not Tested
1/2 91 Pass Fail Not Tested
3/4 85 Pass Fail Not Tested
3/4 91 Pass Fail Not Tested
5/6 85 Pass Fail Not Tested
5/6 91 Pass Fail Not Tested

Technician Comments:
Technician Name:David Mathie
Signature:
Environmental Compliance for Petroleum Systems
©2024 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com
7-ELEVEN 35470 7-ELEVEN, INC.
3311 South 700 East State ID 4000690
Salt Lake City UT 84106
4000690
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 02/15/2024
1 2
RUL PUL
VR350 VR350
14881 9753
90.5 90.5
UT151
David Mathie
3311 South 700 East State ID 4000690
7-ELEVEN 35470
3311 South 700 East State ID 4000690, Salt Lake City, UT 84106
35470
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
02/15/2024
ANNULAR ANNULAR FILL STP FILL STP UDC
RUL PUL RUL RUL PUL PUL 1/2
UT151
David Mathie
3311 South 700 East State ID 4000690
7-ELEVEN 35470
3311 South 700 East State ID 4000690, Salt Lake City, UT 84106
35470
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
02/15/2024
UDC UDC
3/4 5/6
UT151
David Mathie
PVVC tested ==>RUL Manifolded
Final Test Result (Pass / Fail) ==>Fail
PVVC Manuf. ==>OPW Model Number ==>623V-2203
Is this Original or
Replacement?
Original
If this cap is being
replaced, check here:
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)0.05 25 0.0530 Fail
Low High Measured
Pos Cracking (in H2O)2.50 6.00 0.00 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 0.00 Fail
PVVC tested ==>RUL Manifolded
Final Test Result (Pass / Fail) ==>Pass
PVVC Manuf. ==>OPW Model Number ==>723V
Is this Original or
Replacement?
Replacement Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)0.05 6 0.0127 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.57 Pass
Neg Leak Rate (CFH)0.21 19 0.0403 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.04 Pass
PVVC tested ==>PUL Manifolded
Final Test Result (Pass / Fail) ==>Fail
PVVC Manuf. ==>OPW Model Number ==>623V-2203
Is this Original or
Replacement?
Original
If this cap is being
replaced, check here:
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)0.05 25 0.0530 Fail
Low High Measured
Pos Cracking (in H2O)2.50 6.00 0.00 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 0.00 Fail
PVVC tested ==>PUL Manifolded
Final Test Result (Pass / Fail) ==>Pass
PVVC Manuf. ==>OPW Model Number ==>723V
Is this Original or
Replacement?
Replacement Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)0.05 5 0.0106 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.61 Pass
Neg Leak Rate (CFH)0.21 16 0.0339 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.32 Pass
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
PVVC tested ==> Manifolded
Final Test Result (Pass / Fail) ==>
PVVC Manuf. ==>Model Number ==>
Is this Original or
Replacement?
Manf Spec
(CFH)
Measured
Leak Rate
in ml/Min;
Cracking
(in H2O)
Calc CFH
(ml/min
x
.00212)
Result
(Pass /Fail)
Pos Leak Rate(CFH)
Low High Measured
Pos Cracking (in H2O)
Neg Leak Rate (CFH)
Low High Measured
Neg Cracking (in H2O)
11000 N. MOPAC EXPRESSWAY, SUITE 500, AUSTIN, TX 78759
[phone]
QP-08-03-FF-02 Pressure Vacuum Vent Cap TP-201.1E Field Form
Rev C 1/27/2011
Site Overall Test Results: Pass
Total +ve LR: 0.0233
Total -ve LR: 0.0742

Test Date 2/15/2024
Technician Name David Mathie
WO #2364638
Facility Name / Loc #7-ELEVEN 35470 35470
Street 3311 South 700 East State ID 4000690
City, St, Zip Salt Lake City, UT 84106

Pressure Vacuum Vent Cap Test Form TP-201.1E

Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2364638
Site ID / Name:35470 / 7-ELEVEN 35470
Address:3311 South 700 East State ID 4000690
City:Salt Lake City State:UT Zip:84106
W.O.# NW1-2364638
+AAE-
I10100
FEB 15, 2024 10:26 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I11B00
FEB 15, 2024 10:27 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
SERVICE NOTICE SESSION REPORT
START TIME END TIME
FEB 15, 2024 9:15 AM FEB 15, 2024 10:23 AM
FEB 21, 2023 9:11 AM FEB 21, 2023 10:58 AM
MAR 7, 2022 9:08 AM MAR 7, 2022 10:31 AM
MAR 8, 2021 8:52 AM MAR 8, 2021 9:36 AM
MAR 16, 2020 9:46 AM MAR 16, 2020 10:39 AM
MAR 21, 2019 9:36 AM MAR 21, 2019 10:35 AM
MAR 22, 2018 9:24 AM MAR 22, 2018 10:22 AM
MAR 29, 2017 10:30 AM MAR 29, 2017 10:51 AM
MAR 29, 2017 9:47 AM MAR 29, 2017 10:21 AM
APR 1, 2016 9:37 AM APR 1, 2016 10:43 AM
+AAMAAQ-
I90200
FEB 15, 2024 10:27 AM
SOFTWARE REVISION LEVEL
VERSION 332.00
SOFTWARE+ACM- 346332-100-A
CREATED - 11.05.27.16.12
S-MODULE+ACM- 330160-102-A
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
CSLD
BIR
+AAMAAQ-
I20100
FEB 15, 2024 10:27 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP
1 RUL 9743 9795 5138 56.11 0.00 52.16
2 PUL 7852 7906 1901 67.39 0.00 50.04
+AAMAAQ-
I30100
FEB 15, 2024 10:27 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 UNLD STP SUMP SENSOR NORMAL
2 PREM STP SUMP SENSOR NORMAL
3 UNLD FILL SUMP SENSOR NORMAL
4 PREM FILL SUMP SENSOR NORMAL
5 UNLD INTERSTITIAL SENSOR NORMAL
6 PREM INTERSTITIAL SENSOR NORMAL
9 DISP 1-2 PAN SENSOR NORMAL
10 DISP 3-4 PAN SENSOR NORMAL
11 DISP 5-6 PAN SENSOR NORMAL
+AAMAAQ-
I30200
FEB 15, 2024 10:27 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 UNLD STP SUMP
FEB 15, 2024 9:41 AM FUEL ALARM
FEB 3, 2024 6:05 PM FUEL ALARM
NOV 3, 2023 3:37 PM SETUP DATA WARNING
2 PREM STP SUMP
FEB 15, 2024 9:43 AM FUEL ALARM
FEB 21, 2023 9:39 AM FUEL ALARM
MAR 7, 2022 9:47 AM FUEL ALARM
3 UNLD FILL SUMP
FEB 15, 2024 9:46 AM FUEL ALARM
MAR 20, 2023 7:29 PM FUEL ALARM
MAR 15, 2023 6:19 AM FUEL ALARM
4 PREM FILL SUMP
FEB 15, 2024 9:49 AM FUEL ALARM
FEB 21, 2023 10:14 AM FUEL ALARM
MAR 7, 2022 9:37 AM FUEL ALARM
5 UNLD INTERSTITIAL
FEB 15, 2024 9:54 AM FUEL ALARM
FEB 21, 2023 9:50 AM FUEL ALARM
MAR 7, 2022 9:30 AM FUEL ALARM
6 PREM INTERSTITIAL
FEB 15, 2024 9:59 AM FUEL ALARM
FEB 21, 2023 9:52 AM FUEL ALARM
MAR 7, 2022 9:32 AM FUEL ALARM
9 DISP 1-2 PAN
FEB 15, 2024 9:24 AM FUEL ALARM
FEB 21, 2023 9:18 AM FUEL ALARM
MAR 7, 2022 9:51 AM FUEL ALARM
10 DISP 3-4 PAN
FEB 15, 2024 9:21 AM FUEL ALARM
FEB 21, 2023 9:17 AM FUEL ALARM
MAR 7, 2022 9:51 AM FUEL ALARM
11 DISP 5-6 PAN
FEB 15, 2024 9:21 AM FUEL ALARM
FEB 21, 2023 9:17 AM FUEL ALARM
MAR 7, 2022 9:52 AM FUEL ALARM
+AAMAAQ-
IA0100
FEB 15, 2024 10:27 AM
TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 1 RUL MAG D004 96.00 613423 3614
TANK 2 PUL MAG D004 96.00 629849 4514
+AAMAAQ-
931
TANK 1 SETUP CONDITIONS
PRODUCT: RUL
PRODUCT CODE 1
HIGH WATER LIMIT 1.5
OVERFILL LIMIT: 13393
HIGH PRODUCT LIMIT: 14137
LOW PRODUCT: 878
SUDDEN LOSS LIMIT: 25
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 14881 0 0 0 0
3/4 HEIGHT CAPACITY: 12030 0 0 0 0
1/2 HEIGHT CAPACITY: 7477 0 0 0 0
1/4 HEIGHT CAPACITY: 2870 0 0 0 0
TANK DIAMETER: 90.50
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
932
TANK 2 SETUP CONDITIONS
PRODUCT: PUL
PRODUCT CODE 2
HIGH WATER LIMIT 1.5
OVERFILL LIMIT: 8777
HIGH PRODUCT LIMIT: 9265
LOW PRODUCT: 560
SUDDEN LOSS LIMIT: 25
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 9753 0 0 0 0
3/4 HEIGHT CAPACITY: 7910 0 0 0 0
1/2 HEIGHT CAPACITY: 4901 0 0 0 0
1/4 HEIGHT CAPACITY: 1858 0 0 0 0
TANK DIAMETER: 90.50
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
FEB 15, 2024 10:27 AM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
MAY 27, 2011
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
TST EARLY STOP:DISABLED
+AAMAAQ-
I70300
FEB 15, 2024 10:27 AM
LIQUID TYPE
SENSOR LOCATION TYPE
1 UNLD STP SUMP TRI-STATE (SINGLE FLOAT)
2 PREM STP SUMP TRI-STATE (SINGLE FLOAT)
3 UNLD FILL SUMP TRI-STATE (SINGLE FLOAT)
4 PREM FILL SUMP TRI-STATE (SINGLE FLOAT)
5 UNLD INTERSTITIAL TRI-STATE (SINGLE FLOAT)
6 PREM INTERSTITIAL TRI-STATE (SINGLE FLOAT)
7 TRI-STATE (SINGLE FLOAT)
8 TRI-STATE (SINGLE FLOAT)
9 DISP 1-2 PAN TRI-STATE (SINGLE FLOAT)
10 DISP 3-4 PAN TRI-STATE (SINGLE FLOAT)
11 DISP 5-6 PAN TRI-STATE (SINGLE FLOAT)
12 TRI-STATE (SINGLE FLOAT)
13 TRI-STATE (SINGLE FLOAT)
14 TRI-STATE (SINGLE FLOAT)
15 TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE FLOAT)
+AAMAAQ-
I80800
FEB 15, 2024 10:27 AM
RELAY SETUP REPORT
R 1:
TYPE:
STANDARD
NORMALLY OPEN
- NO ALARM ASSIGNMENTS -
R 2:
TYPE:
STANDARD
NORMALLY OPEN
- NO ALARM ASSIGNMENTS -
R 3:
TYPE:
STANDARD
NORMALLY OPEN
- NO ALARM ASSIGNMENTS -
R 4:
TYPE:
STANDARD
NORMALLY OPEN
- NO ALARM ASSIGNMENTS -
+AAMAAQ-
I10200
FEB 15, 2024 10:27 AM
171245 7-11 35470
704 E. 3300 S.
SALT LAKE CITY, UX.
L12216065205001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 INTERSTITIAL BD 201945 201022
2 INTERSTITIAL BD 202034 201298
3 4 PROBE / G.T. 163650 163141
4 UNUSED 9348314 9326254
5 UNUSED 9331347 9315305
6 UNUSED 9328237 9315724
7 UNUSED 9329417 9319910
8 UNUSED 9326692 9315460
9 RELAY BOARD 14992 15029
10 UNUSED 9332283 9319654
11 UNUSED 9321623 9320028
12 UNUSED 9326663 9318222
13 UNUSED 9320936 9318508
14 UNUSED 9325355 9314631
15 UNUSED 9319950 9316702
16 UNUSED 9325891 9316526
COMM 1 ELEC DISP INT. 100948 100784
COMM 2 UNUSED 100729 9316856
COMM 3 SERIAL SAT BD 9331983 484920
COMM 4 UNUSED 9325119 9317363
COMM 5 RS485 SERIAL BD 9321558 68819
COMM 6 MT COMM BOARD 9322545 408933
+AAM-