DERR-2024-010378

IMPACT VALVE
LEAK DETECTOR
MONITOR CERTIFICATION
OVERFILL OPERABILITY
PV VENT CAP
STAGE 1 PD
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 8/26/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 8/22/2024
Order Number: 2370464
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN 41600
5652 W 4700 S
State ID 4002593
West Valley, UT 84128
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN 41600
5652 W 4700 S State ID 4002593
West Valley UT 84128
41600
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
08/22/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000
Vaporless LD-
2000
30
30
175
2
20
3
30
30
175
2
20
3
32
32
110
2
20
3
UT151
David Mathie
NW1-2370464
Low Sulfur Diesel
TTNK1:1 TTNK2:1 TTNK3:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2370464 Date:8/22/2024
Site Name/ID:7-ELEVEN 41600
Address:5652 W 4700 S State ID 4002593
City:West Valley State:UT Zip:84128
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 85 Pass Fail Not Tested
5/6 91 Pass Fail Not Tested
7/8 85 Pass Fail Not Tested
7/8 91 Pass Fail Not Tested
9/10 40 Pass Fail Not Tested
9/10 85 Pass Fail Not Tested
9/10 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 41600 7-ELEVEN, INC.
5652 W 4700 S State ID 4002593
West Valley UT 84128
4002593
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 08/22/2024
1 2 3
RUL PUL DSL
VR350 VR350 VR350
19782 7901 11904
118.38 118.38 118.38
UT151
David Mathie
5652 W 4700 S State ID 4002593
7-ELEVEN 41600
5652 W 4700 S State ID 4002593, West Valley, UT 84128
41600
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
08/22/2024
ANNULAR ANNULAR SB FILL STP SB FILL STP SB FILL
RUL PUL/DSL RUL RUL PUL PUL DSL
UT151
David Mathie
5652 W 4700 S State ID 4002593
7-ELEVEN 41600
5652 W 4700 S State ID 4002593, West Valley, UT 84128
41600
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
08/22/2024
STP UDC UDC UDC UDC UDC
DSL 1/2 3/4 5/6 7/8 9/10
UT151
David Mathie
2 inch Pressure Decay Test
TP201.3

Store Information Testing Company
Site Name :7-ELEVEN 41600 Name :TANKNOLOGY INC.
Address :5652 W 4700 S State ID 4002593
West Valley, UT 84128
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 :10
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)
TNK1
RUL
19782
11906
7876

12:44
2.00
2.00
2.00
1.99
1.99
1.98
1.88
Pass
TNK2
PUL
7901
3101
4800

12:52
2.00
2.00
2.00
2.00
1.99
1.99
1.81
Pass

Total

27683
15007
12676
All

Comments:

Tester :David Mathie Test Date :8/22/2024
Signature :Work Order :2370464

WO: 2370464
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 20 0.0424 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 2.09 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -2.16 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 4 0.0085 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.61 Pass
Neg Leak Rate (CFH)0.21 15 0.0318 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.83 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 20 0.0424 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 2.12 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -2.21 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 3.57 Pass
Neg Leak Rate (CFH)0.21 17 0.0360 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.83 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: 0.0212
Total -ve LR: 0.0678

Test Date 8/22/2024
Technician Name David Mathie
WO #2370464
Facility Name / Loc #7-ELEVEN 41600 41600
Street 5652 W 4700 S State ID 4002593
City, St, Zip West Valley, UT 84128

Pressure Vacuum Vent Cap Test Form TP-201.1E

7-ELEVEN 41600
5652 W 4700 S State ID 4002593
West Valley, UT 84128
41600
Tanknology, Inc.
7-ELEVEN, INC.
972-828-7575
800-800-4633 08/22/2024
RUL
1
19782
118.375
OPW
PUL
2
7901
118.375
OPW
DSL
3
11904
118.375
OPW
UT151
David Mathie
P.O. BOX 711
DALLAS, TX 75221
Overfill Prevention Equipment Inspection
OPW 61 and 71 Series Overfill Prevention Device Inspection
Date:8/22/2024
Customer Name:7-ELEVEN, INC.
Location #:7-ELEVEN 41600
Location Address:5652 W 4700 S State ID 4002593 ,West Valley ,UT , 84128
OPW Model Number:7160

PART 1) Proper height setting calculation
Maximum Tank Volume per: Tank Chart A gallons
Max shut off requirement for Flapper is 95% B 95%
Multiply Maximum tank volume by 95% C gallons
Use tank chart to determine height of calculated volume D inches
Measure top of fill riser threads, or face seal adapter when used, to tank top E inches
Tank diameter From Chart F inches
Upper Tube in tank (G) F - D = G G inches
Subtract 2 inches from upper tube in tank G - 2"= H H inches
Calculated minimum upper tube length (I) H + E = I I inches
Actual measured upper tube length (Without fill
adapter) (J) J inches
PART 2) Device certification criteria evaluation
Criteria 1
Does the overfill prevention device meet the 95% requirement?

Criteria 1a If the final shutoff volume is installed greater than 95%, is there at
least 250 gallons of ullage above the overfill device activation point
to ensure that none of the tank top fittings are exposed to product,
meeting the criteria established in EPA 280.20iic and per OPW
installation guidelines.

Criteria 2 Is the Actual measured upper tube length 6.5 inches
or more than the fill riser? (J must be 6.5" or more
than E)

Criteria 3 Does the overfill prevention device function as
required? (Inspect the device for damage,
contamination, freedom of movement,
weakening due to wear and corrosion)
PART 3) Device Certification PASS / FAIL
Technician certifies that the device is operationally
compliant.

TNK1

19782.000
0.95
18792.900
106.375
36.250
118.375
12.000
10.000
46.250
49.750
Yes

NA

Yes

Yes

Pass
TNK2

7901.000
0.95
7505.950
106.875
42.000
118.375
11.500
9.500
51.500
56.375
Yes

NA

Yes

Yes

Pass
TNK3

11904.000
0.95
11308.800
105.875
40.000
118.375
12.500
10.500
50.500
53.750
Yes

NA

Yes

Yes

Pass

0.95

Comments:
Signature of Technician: Date: 8/22/2024

David Mathie
WO: NW1- 2370464
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2370464
Site ID / Name:41600 / 7-ELEVEN 41600
Address:5652 W 4700 S State ID 4002593
City:West Valley State:UT Zip:84128
W.O.# NW1-2370464
+AAE-
I10100
AUG 22, 2024 12:42 PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT

W01276256905001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I90200
AUG 22, 2024 12:42 PM
SOFTWARE REVISION LEVEL
VERSION 336.01
SOFTWARE+ACM-
346336-100-B
CREATED - 20.04.26.20.30
S-MODULE+ACM- 330160-100-a
SYSTEM FEATURES:

PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
BIR
+AAMAAQ-
I11B00
AUG 22, 2024 12:42
PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT
W01276256905001
SERVICE NOTICE SESSION REPORT
START TIME END TIME
AUG 22, 2024 11:34 AM
AUG 22, 2024 12:38 PM
APR 9, 2024 9:19 AM APR 9, 2024 11:47 AM
AUG 23, 2023 12:12 PM
AUG 23, 2023 12:55 PM
AUG 31, 2022 9:22 AM AUG 31, 2022 10:54 AM
+AAMAAQ-
I20100
AUG
22, 2024 12:42 PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT
W01276256905001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME
ULLAGE HEIGHT WATER TEMP
1 RUL 11892 11808 7890 68.36
0.50 70.20
2 PUL 3103 3088 4798 49.05 0.00 66.89
3
DSL 3288 3280 8616 39.06 0.00 65.26
+AAMAAQ-
I30100
AUG
22, 2024 12:42 PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT
W01276256905001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1
RUL ANNULAR SENSOR NORMAL
2 DSL-PUL ANNULAR SENSOR NORMAL
3 RUL
SPILL BKT SENSOR NORMAL
4 RUL STP SENSOR NORMAL
5 PUL SPILL
BKT SENSOR NORMAL
6 PUL STP SENSOR NORMAL
7 DSL SPILL BKT
SENSOR NORMAL
8 DSL STP SENSOR NORMAL
9 DISP 1-2
SENSOR NORMAL
10 DISP 3-4 SENSOR NORMAL
11 DISP 5-6 SENSOR
NORMAL
12 DISP 7-8 SENSOR NORMAL
13 DISP 9-10 SENSOR
NORMAL
+AAMAAQ-
I30200
AUG 22, 2024 12:42 PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT
W01276256905001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION

1 RUL ANNULAR
AUG 22, 2024 12:22 PM FUEL ALARM
AUG 23, 2023
11:55 AM FUEL ALARM
AUG 31, 2022 10:14 AM FUEL ALARM
2 DSL-PUL
ANNULAR
AUG 22, 2024 12:17 PM FUEL ALARM
AUG 23, 2023 12:29 PM
FUEL ALARM
AUG 31, 2022 10:19 AM FUEL ALARM
3 RUL SPILL BKT

AUG 22, 2024 11:47 AM FUEL ALARM
AUG 23, 2023 12:07 PM FUEL ALARM

AUG 31, 2022 10:29 AM FUEL ALARM
4 RUL STP
AUG 22, 2024
11:54 AM FUEL ALARM
AUG 23, 2023 12:10 PM FUEL ALARM
AUG 31, 2022
10:01 AM FUEL ALARM
5 PUL SPILL BKT
AUG 22, 2024 11:57 AM
FUEL ALARM
AUG 23, 2023 12:19 PM FUEL ALARM
AUG 31, 2022 10:32 AM
FUEL ALARM
6 PUL STP
AUG 22, 2024 11:57 AM FUEL ALARM

AUG 23, 2023 12:20 PM FUEL ALARM
AUG 31, 2022 10:03 AM FUEL ALARM
7
DSL SPILL BKT
AUG 22, 2024 12:08 PM FUEL ALARM
AUG 23, 2023
12:23 PM FUEL ALARM
AUG 31, 2022 10:36 AM FUEL ALARM
8 DSL STP

AUG 22, 2024 11:57 AM FUEL ALARM
AUG 23, 2023 12:24 PM
FUEL ALARM
AUG 31, 2022 10:05 AM FUEL ALARM
9 DISP 1-2

AUG 22, 2024 12:05 PM FUEL ALARM
AUG 23, 2023 11:08 AM FUEL ALARM

AUG 31, 2022 9:51 AM FUEL ALARM
10 DISP 3-4
AUG 22, 2024
12:05 PM FUEL ALARM
AUG 23, 2023 11:09 AM FUEL ALARM
AUG 31, 2022
9:51 AM FUEL ALARM
11 DISP 5-6
AUG 22, 2024 12:06 PM
FUEL ALARM
AUG 23, 2023 11:09 AM FUEL ALARM
AUG 31, 2022 9:51 AM
FUEL ALARM
12 DISP 7-8
AUG 22, 2024 12:07 PM FUEL ALARM

AUG 23, 2023 11:15 AM FUEL ALARM
AUG 31, 2022 9:52 AM FUEL ALARM
13
DISP 9-10
AUG 23, 2023 11:10 AM FUEL ALARM
AUG 31, 2022
9:52 AM FUEL ALARM
+AAMAAQ-
IA0100
AUG 22, 2024 12:42 PM

TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 1 RUL MAG D004 126.00
262176 1294
TANK 2 PUL MAG D004 126.00 410604 4304
TANK 3
DSL MAG D004 126.00 380557 2404
+AAMAAQ-
931
TANK 1 SETUP
CONDITIONS
PRODUCT: RUL
PRODUCT CODE 1
HIGH WATER LIMIT
1.0
OVERFILL LIMIT: 17803
HIGH PRODUCT LIMIT: 18792
LOW PRODUCT:
1504
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF:
0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 19782 0 0 0
0
3/4 HEIGHT CAPACITY: 16033 0 0 0 0
1/2 HEIGHT CAPACITY: 9897
0 0 0 0
1/4 HEIGHT CAPACITY: 3718 0 0 0 0
TANK
DIAMETER: 118.38
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 1.0
OVERFILL LIMIT: 7110
HIGH PRODUCT
LIMIT: 7505
LOW PRODUCT: 651
SUDDEN LOSS LIMIT: 99
LEAK LIMIT:
99
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 7901
0 0 0 0
3/4 HEIGHT CAPACITY: 6356 0 0 0 0
1/2
HEIGHT CAPACITY: 3964 0 0 0 0
1/4 HEIGHT CAPACITY: 1551 0
0 0 0
TANK DIAMETER: 118.38
TANK TILT ADDER: 0.00
MANIFOLDED TANKS:
NONE
TANK CONFIGURED: NO
+AAMAAQ-
933
TANK 3 SETUP CONDITIONS
PRODUCT:
DSL
PRODUCT CODE 3
HIGH WATER LIMIT 1.0
OVERFILL LIMIT:
10713
HIGH PRODUCT LIMIT: 11308
LOW PRODUCT: 855
SUDDEN LOSS LIMIT:
99
LEAK LIMIT: 99
THERMAL COEFF: 0.000450
DELIVERY DELAY: 5
TANK
FULL CAPACITY: 11904 0 0 0 0
3/4 HEIGHT CAPACITY: 9696 0
0 0 0
1/2 HEIGHT CAPACITY: 5944 0 0 0 0
1/4 HEIGHT
CAPACITY: 2172 0 0 0 0
TANK DIAMETER: 118.38
TANK TILT ADDER:
0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
AUG 22, 2024
12:42 PM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
APR 26,
2020
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
TST EARLY
STOP:DISABLED
+AAMAAQ-
I70300
AUG 22, 2024 12:42 PM
LIQUID TYPE
SENSOR LOCATION
TYPE
1 RUL ANNULAR TRI-STATE (SINGLE FLOAT)
2 DSL-PUL ANNULAR
TRI-STATE (SINGLE FLOAT)
3 RUL SPILL BKT NORMALLY CLOSED
4 RUL STP
TRI-STATE (SINGLE FLOAT)
5 PUL SPILL BKT NORMALLY CLOSED
6 PUL STP
TRI-STATE (SINGLE FLOAT)
7 DSL SPILL BKT NORMALLY CLOSED
8 DSL STP
TRI-STATE (SINGLE FLOAT)
9 DISP 1-2 TRI-STATE (SINGLE FLOAT)

10 DISP 3-4 TRI-STATE (SINGLE FLOAT)
11 DISP 5-6 TRI-STATE
(SINGLE FLOAT)
12 DISP 7-8 TRI-STATE (SINGLE FLOAT)
13 DISP 9-10
TRI-STATE (SINGLE FLOAT)
14 TRI-STATE (SINGLE FLOAT)
15
TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE
FLOAT)
+AAMAAQ-
I80800
AUG 22, 2024 12:42 PM
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
AUG 22, 2024 12:43
PM
7-11 41600
4682 S 5600 W
WEST VALLEY,UT
W01276256905001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 4
PROBE / G.T. 162489 161702
2 INTERSTITIAL BD
200220 199650
3 INTERSTITIAL BD 199929 199536
4
UNUSED 9650979 9530588
5 UNUSED
9624572 9523550
6 UNUSED 9615970 9522460
7
UNUSED 9614061 9520478
8 UNUSED
9615863 9522351
9 RELAY BOARD 14993 14985
10
UNUSED 9622891 9531152
11 UNUSED
9611200 9526991
12 UNUSED 9611586 9524223
13
UNUSED 9609441 9521282
14 UNUSED
9606781 9517403
15 UNUSED 9611608 9525487
16
UNUSED 9610964 9524419
COMM 1 ELEC DISP INT.
100617 100555
COMM 2 UNUSED 9618022 9523766
COMM
3 SERIAL SAT BD 480473 480187
COMM 4 UNUSED 9615512
9527208
COMM 5 RS485 SERIAL BD 9609806 68199
COMM 6 MT
COMM BOARD 9604207 404414
+AAM-