DERR-2024-010257

IMPACT VALVE
LEAK DETECTOR
MONITOR CERTIFICATION
PV VENT CAP
STAGE 1 PD
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 8/23/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 8/21/2024
Order Number: 2370466
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN 16449, MKT 1606
3720 EAST 7000 SOUTH
State ID 4000998
SALT LAKE CITY, UT 84121
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN 16449, MKT 1606
3720 EAST 7000 SOUTH State ID 4000998
SALT LAKE CITY UT 84121
16449
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
08/21/2024
RUL Low Sulfur Diesel
Vaporless LD-
2000
Vaporless LD-
2000
Vaporless LD-
2000
30
30
130
4
20
5
30
30
130
2
20
3
30
30
70
2
20
3
UT151
David Mathie
NW1-2370466
PUL
TTNK4
REGULAR:1
TTNK5 DIESEL:1 TTNK6 PREMIUM:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2370466 Date:8/21/2024
Site Name/ID:7-ELEVEN 16449, MKT 1606
Address:3720 EAST 7000 SOUTH State ID 4000998
City:SALT LAKE CITY State:UT Zip:84121
How Inspected: Line Test NFPA 30A PEI RP1200 Other STP PRESSURE
Dispenser
Number Grade
Secure
Mount?
Valve
Lock?Pass/ Fail Comments
1/2 40 Pass Fail Not Tested
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 40 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 16449, MKT 1606 7-ELEVEN, INC.
3720 EAST 7000 SOUTH State ID 4000998
SALT LAKE CITY UT 84121
4000998
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 08/21/2024
4 5 6
RUL DSL PUL
VR350 VR350 VR350
19782 11904 7901
118.37 118.37 118.37
UT151
David Mathie
3720 EAST 7000 SOUTH State ID 4000998
7-ELEVEN 16449, MKT 1606
3720 EAST 7000 SOUTH State ID 4000998, SALT LAKE CITY, UT
8412116449
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
08/21/2024
ANNULAR ANNULAR FILL STP FILL STP FILL
RUL PUL/DSL RUL RUL PUL PUL DSL
UT151 RUL FILL SENSOR IN ALARM CLEARED AND RETESTED WAITING FOR MANTIANCE TO CLEAN OUT
David Mathie
3720 EAST 7000 SOUTH State ID 4000998
7-ELEVEN 16449, MKT 1606
3720 EAST 7000 SOUTH State ID 4000998, SALT LAKE CITY, UT
8412116449
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
08/21/2024
DSL UDC UDC UDC
STP 1/2 3/4 5/6
UT151
David Mathie
2 inch Pressure Decay Test
TP201.3

Store Information Testing Company
Site Name :7-ELEVEN 16449, MKT 1606 Name :TANKNOLOGY INC.
Address :3720 EAST 7000 SOUTH State ID 4000998
SALT LAKE CITY, UT 84121
Address :11000 N. MoPac Expressway Suite 500
Austin, TX 78759
Phone :[phone] Phone :[phone]

Stage I System?DUAL
Stage II System?NONE
Total # of Nozzles :6
Products per Nozzle :3
Tanks Manifolded ?No
Drop-Out tank present?NO
Total # of Tanks Tested :2

Tank Information :
Product Grade :
Tank Capacity, gallons :
Gasoline, gallons :
Ullage, gallons :
Testing Information :
Start Time :
Initial Pressure, wcg :
Pressure @ 1 minute(s) :
Pressure @ 2 minutes :
Pressure @ 3 minutes :
Pressure @ 4 minutes :
Pressure @ 5 minutes :
Allowable Final Pressure :
Pass/Fail (Enter "GF" Gross Failure)
TNK4 REGULAR
RUL
19782
14446
5336

13:22
2.00
2.00
2.00
1.99
1.99
1.98
1.83
Pass
TNK6 PREMIUM
PUL
7901
2760
5141

13:30
2.00
2.00
1.99
1.99
1.98
1.98
1.82
Pass

Total

27683
17206
10477
All

Comments:

Tester :David Mathie Test Date :8/21/2024
Signature :Work Order :2370466

WO: 2370466
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 1.91 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -2.17 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 5 0.0106 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.62 Pass
Neg Leak Rate (CFH)0.21 16 0.0339 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.96 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 1.77 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -1.98 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 6 0.0127 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.69 Pass
Neg Leak Rate (CFH)0.21 14 0.0297 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -8.05 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: 0.0636

Test Date 8/21/2024
Technician Name David Mathie
WO #2370466
Facility Name / Loc #7-ELEVEN 16449, MKT 1606 16449
Street 3720 EAST 7000 SOUTH State ID 4000998
City, St, Zip SALT LAKE CITY, UT 84121

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:2370466
Site ID / Name:16449 / 7-ELEVEN 16449, MKT 1606
Address:3720 EAST 7000 SOUTH State ID 4000998
City:SALT LAKE CITY State:UT Zip:84121
W.O.# NW1-2370466
+AAE-i101002408211412021105030304+ACYAJg-FA0C+AAMAAQ-
I10101
AUG 21, 2024 2:12 PM
176936 7-11
16449
3720 FORT UNION BLVD
SLC UT 84121
90558298205001
SYSTEM STATUS
REPORT
T 5:DELIVERY NEEDED
L 4:FUEL ALARM
+AAMAAQ-
I90200
AUG 21, 2024 2:12
PM
SOFTWARE REVISION LEVEL
VERSION 333.04
SOFTWARE+ACM- 346333-100-E
CREATED -
13.06.07.08.25
S-MODULE+ACM- 330160-102-A
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
ANNUAL
IN-TANK TESTS
CSLD
BIR
+AAMAAQ-
I11B00
AUG 21, 2024 2:12 PM
176936 7-11 16449
3720 FORT UNION BLVD
SLC UT 84121
90558298205001
SERVICE NOTICE SESSION
REPORT
START TIME END TIME
AUG 21, 2024 12:33 PM AUG 21, 2024 2:09 PM
AUG
24, 2023 9:08 AM AUG 24, 2023 12:24 PM
SEP 7, 2022 8:39 AM SEP 7, 2022 10:22 AM
NOV
19, 2021 11:58 AM NOV 19, 2021 12:17 PM
SEP 23, 2020 8:52 AM SEP 23, 2020 12:24 PM
SEP
26, 2019 8:57 AM SEP 26, 2019 10:06 AM
+AAMAAQ-
I20100
AUG 21, 2024 2:12
PM
176936 7-11 16449
3720 FORT UNION BLVD
SLC UT 84121
90558298205001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT
WATER TEMP
4 RUL 14433 14260 5349 80.50 0.00 77.38
5
DSL 1722 1711 10182 25.26 0.00 74.40
6 PUL
2760 2727 5141 44.90 0.00 77.06
+AAMAAQ-
I30100
AUG 21, 2024 2:12
PM
176936 7-11 16449
3720 FORT UNION BLVD
SLC UT 84121
90558298205001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 RUL INTERSTITIAL
SENSOR NORMAL
2 PUL-DSL INTERSTITIAL SENSOR NORMAL
3 RUL STP SUMP SENSOR
NORMAL
4 RUL FILL SUMP FUEL ALARM
5 PUL STP SUMP SENSOR NORMAL

6 PUL FILL SUMP SENSOR NORMAL
7 DSL STP SUMP SENSOR NORMAL
9
DISPENSER PAN 1-2 SENSOR NORMAL
10 DISPENSER PAN 3-4 SENSOR NORMAL
11
DISPENSER PAN 5-6 SENSOR NORMAL
12 DSL FILL SENSOR
NORMAL
+AAMAAQ-
I30200
AUG 21, 2024 2:12 PM
176936 7-11 16449
3720 FORT UNION
BLVD
SLC UT 84121
90558298205001
LIQUID ALARM HISTORY REPORT
SENSOR
LOCATION
1 RUL INTERSTITIAL
AUG 24, 2023 10:01 AM FUEL ALARM

SEP 7, 2022 8:59 AM FUEL ALARM
NOV 19, 2021 12:02 PM FUEL ALARM
2
PUL-DSL INTERSTITIAL
AUG 21, 2024 1:36 PM FUEL ALARM
AUG 24, 2023 10:03
AM FUEL ALARM
SEP 7, 2022 8:49 AM FUEL ALARM
3 RUL STP SUMP

AUG 21, 2024 1:17 PM FUEL ALARM
AUG 24, 2023 9:29 AM FUEL
ALARM
SEP 7, 2022 9:07 AM FUEL ALARM
4 RUL FILL SUMP
AUG
21, 2024 1:00 PM FUEL ALARM
AUG 20, 2024 12:08 PM FUEL ALARM
MAY
6, 2024 11:00 AM FUEL ALARM
5 PUL STP SUMP
AUG 21, 2024 1:18 PM
FUEL ALARM
AUG 24, 2023 10:44 AM FUEL ALARM
AUG 24, 2023 9:40 AM
FUEL ALARM
6 PUL FILL SUMP
AUG 21, 2024 1:05 PM FUEL
ALARM
AUG 24, 2023 10:25 AM FUEL ALARM
SEP 7, 2022 9:21 AM FUEL
ALARM
7 DSL STP SUMP
AUG 21, 2024 1:18 PM FUEL ALARM
AUG
24, 2023 9:45 AM FUEL ALARM
DEC 13, 2022 11:29 AM FUEL ALARM
9
DISPENSER PAN 1-2
AUG 21, 2024 1:23 PM FUEL ALARM
MAY 19, 2024 12:28
PM FUEL ALARM
AUG 24, 2023 9:18 AM FUEL ALARM
10 DISPENSER PAN 3-4

AUG 21, 2024 1:23 PM FUEL ALARM
AUG 24, 2023 9:18 AM FUEL
ALARM
SEP 7, 2022 10:08 AM FUEL ALARM
11 DISPENSER PAN 5-6
AUG
21, 2024 1:24 PM FUEL ALARM
AUG 24, 2023 9:18 AM FUEL ALARM
SEP
7, 2022 10:09 AM FUEL ALARM
12 DSL FILL
AUG 21, 2024 1:12 PM
FUEL ALARM
AUG 24, 2023 10:18 AM FUEL ALARM
APR 3, 2023 4:15 AM
FUEL ALARM
+AAMAAQ-
IA0100
AUG 21, 2024 2:13 PM
TYPE
CODE LENGTH SERIAL NO. D/CODE
TANK 4 RUL MAG D004 126.00 669483
2324
TANK 5 DSL MAG D004 120.00 546610 3904
TANK 6 PUL
MAG D004 120.00 535813 3104
+AAMAAQ-
934
TANK 4 SETUP
CONDITIONS
PRODUCT: RUL
PRODUCT CODE 4
HIGH WATER LIMIT
1.5
OVERFILL LIMIT: 17803
HIGH PRODUCT LIMIT: 18793
LOW PRODUCT:
747
SUDDEN LOSS LIMIT: 25
LEAK LIMIT: 15
THERMAL COEFF:
0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 19782 19443 18825 18025
17087
3/4 HEIGHT CAPACITY: 16039 14906 13705 12457 11178
1/2 HEIGHT CAPACITY: 9883
8588 7310 6064 4866
1/4 HEIGHT CAPACITY: 3735 2690 1756 960 345
TANK
DIAMETER: 118.37
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED:
NO
+AAMAAQ-
935
TANK 5 SETUP CONDITIONS
PRODUCT: DSL
PRODUCT CODE 5
HIGH WATER LIMIT 1.5
OVERFILL LIMIT: 10713
HIGH PRODUCT
LIMIT: 11308
LOW PRODUCT: 416
SUDDEN LOSS LIMIT: 25
LEAK LIMIT:
15
THERMAL COEFF: 0.000450
DELIVERY DELAY: 5
TANK FULL CAPACITY: 11904
0 0 0 0
3/4 HEIGHT CAPACITY: 9710 0 0 0 0
1/2
HEIGHT CAPACITY: 5944 0 0 0 0
1/4 HEIGHT CAPACITY: 2186 0
0 0 0
TANK DIAMETER: 118.37
TANK TILT ADDER: 0.00
MANIFOLDED TANKS:
NONE
TANK CONFIGURED: NO
+AAMAAQ-
936
TANK 6 SETUP CONDITIONS
PRODUCT:
PUL
PRODUCT CODE 6
HIGH WATER LIMIT 1.5
OVERFILL LIMIT:
7110
HIGH PRODUCT LIMIT: 7506
LOW PRODUCT: 332
SUDDEN LOSS LIMIT:
25
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK
FULL CAPACITY: 7901 0 0 0 0
3/4 HEIGHT CAPACITY: 6360 0
0 0 0
1/2 HEIGHT CAPACITY: 3960 0 0 0 0
1/4 HEIGHT
CAPACITY: 1558 0 0 0 0
TANK DIAMETER: 118.37
TANK TILT ADDER:
0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
AUG 21, 2024
2:13 PM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
NOV 6, 2012
START
TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
TST EARLY
STOP:DISABLED
+AAMAAQ-
I70300
AUG 21, 2024 2:13 PM
LIQUID TYPE
SENSOR LOCATION
TYPE
1 RUL INTERSTITIAL TRI-STATE (SINGLE FLOAT)
2 PUL-DSL INTERSTITIAL
TRI-STATE (SINGLE FLOAT)
3 RUL STP SUMP TRI-STATE (SINGLE FLOAT)
4 RUL FILL
SUMP TRI-STATE (SINGLE FLOAT)
5 PUL STP SUMP TRI-STATE (SINGLE FLOAT)

6 PUL FILL SUMP TRI-STATE (SINGLE FLOAT)
7 DSL STP SUMP TRI-STATE
(SINGLE FLOAT)
8 DSL FILL SUMP TRI-STATE (SINGLE FLOAT)
9 DISPENSER PAN 1-2
TRI-STATE (SINGLE FLOAT)
10 DISPENSER PAN 3-4 TRI-STATE (SINGLE FLOAT)
11
DISPENSER PAN 5-6 TRI-STATE (SINGLE FLOAT)
12 DSL FILL 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
AUG 21, 2024 2:13
PM
+AAMAAQ-9999FF1B+AAMAAQ-
I10200
AUG 21, 2024 2:13 PM
176936 7-11 16449
3720 FORT
UNION BLVD
SLC UT 84121
90558298205001
SYSTEM CONFIGURATION
SLOT BOARD TYPE
POWER ON RESET CURRENT
1 4 PROBE / G.T. 163830
162735
2 4 PROBE / G.T. 163159 162687
3 INTERSTITIAL BD
200836 200173
4 INTERSTITIAL BD 200953
200245
5 UNUSED 9359836 9051271
6 UNUSED
9340073 9043665
7 UNUSED 9339894
9041678
8 UNUSED 9334468 9038938
9 UNUSED
9335847 9044002
10 UNUSED 9332967
9040074
11 UNUSED 9336048 9036579
12 UNUSED
9329104 9042837
13 UNUSED 9327139
9041170
14 UNUSED 9332007 9033724
15 UNUSED
9335334 9027398
16 UNUSED 9329081
9039526
COMM 1 UNUSED 100423 9039777
COMM 2 ELEC DISP
INT. 100834 100533
COMM 3 SERIAL SAT BD 481012
479502
COMM 4 UNUSED 9336428 9045533
COMM 5 RS485 SERIAL
BD 68705 68608
COMM 6 MT COMM BOARD 408736
407943
+AAM-