DERR-2024-012233

IMPACT VALVE
LEAK DETECTOR
Line Tightness Test
OVERFILL OPERABILITY
PV VENT CAP
STAGE 1 PD
Tank Tightness Test
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 11/13/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 12/15/2023
Order Number: 2366078
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
WALMART #7168 (WM7168)
13352 S FORT HERRIMAN PKWY
HERRIMAN, UT 84096
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
Product Line Tightness Test Page 1 of 1
Work Order: 2366078 Date:
Site Name/ID: WALMART #7168 / WM7168
Address: 13352 S FORT HERRIMAN PKWY
City: HERRIMAN State: UT Zip: 84096
Tank Information
Test Method
Customer Tank ID
Product Name
Delivery Type
Test Pressure (psi)
Test Start Time
Test End Time
Final Leak Rate (gph)
Test Result(P/F/I)
Test was performed per
3rd party certifications as
specified in 40 CFR parts
280 and 281
Tank #
Line #

Tank #
Line #

Tank #
Line #

Tank #
Line #

Tank #
Line #

Tank #
Line #

Technician Comments:
Technician Name:Non Tech WO Certification #:
Technician Signature:

Environmental Compliance for Petroleum Systems
©2024 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com
2 inch Pressure Decay Test
TP201.3

Store Information Testing Company
Site Name :WALMART #7168 Name :TANKNOLOGY INC.
Address :13352 S FORT HERRIMAN PKWY
HERRIMAN, UT 84096
Address :11000 N. MoPac Expressway Suite 500
Austin, TX 78759
Phone :-Phone :[phone]

Stage I System?
Stage II System?
Total # of Nozzles :
Products per Nozzle :
Tanks Manifolded ?
Drop-Out tank present?
Total # of Tanks Tested :

Tank Information :
Product Grade :
Tank Capacity, gallons :
Gasoline, gallons :
Ullage, gallons :
Testing Information :
Start Time :
Initial Pressure, wcg :
Pressure @ minute(s) :
Pressure @ minutes :
Pressure @ minutes :
Pressure @ minutes :
Pressure @ minutes :
Allowable Final Pressure :
Pass/Fail (Enter "GF" Gross Failure)

Total

All

Comments:

Tester :Non Tech WO Test Date :
Signature :Work Order :2366078

WO: 2366078
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam's Club (Walmart) #7168
13352 S. Fort Herriman Pkwy.
Herriman, UT
12/15/2023
19,782
13,212
6,570
REG
1
4
4
Max LaRou UT-412
12-15-23
EZY 3 LOCATOR PLUS
Manufactured by ESTABROOKS, INC 877-368-7215
TEST DATE Location
TANK #
TIGHT TANK
THIS UNDERGROUND STORAGE TANK PASSES THE CRITERIA SET FORTH BY THE U.S. EPA.
ULLAGE (DRY) PORTION OF LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
FINAL REPORT
STATE FACILITY ID#
PRODUCT TYPE
ULLAGE VOL.
PRODUCT VOL.
TOTAL TANK VOL.
THE ACOUSTIC CHARACTERISTIC OF A LEAK REVEALS:
BELOW PRODUCT LEVEL (WET) PORTION LEAK
THIS UNDERGROUND STORAGE TANK FAILS THE CRITERIA SET FORTH BY THE U.S. EPA.
Print Name
Testing Firm
Address
Certification #
Expiration Date:
Telephone #[phone]
Operator Information
No Water Intrusion
Water Instrusion
Not Applicable
WATER SENSOR INDICATES:
(CHECK ONLY ONE)
Precision Testing Tech, Inc.
2026 Elk Creek Crt. Bluffdale, UT
Sam's Club (Walmart) #7168
13352 S. Fort Herriman Pkwy.
Herriman, UT
12/15/2023
11,904
9,415
2,489
REG
2
4
4
Max LaRou UT-412
EZY CHEK SYSTEMS TEST DATE
PRODUCT LINE TESTER Testing Company Information
DATA SHEET Name
Address
City
Test Location Information
Precision Testing Technologies, Inc.
2026 W. Elk Creek Crt.
Bluffdale, UT
Test Location Information Phone
Name
Address Technican Information
City Name
Phone Cert #
801-886-9224
Contact
Applied Pressure
#1 Product Type:#2 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.00370.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
#3 Product Type:#4 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.00370.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
#5 Product Type:#6 Product Type:
TIME DATA -/+GPL RES GPH TIME DATA -/+GPL RES GPH
0 0.0037 0.0000 0.0000 0 0.0037 0.0000 0.000000.0037 0.0000 0.0000 0 0.0037 0.0000 0.0000
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
0.0037 0.0037
FINAL RESULT:FINAL RESULT:
Facility ID#
:
12/15/2023
Sam's Club #7168
13352 S. Fort Herriman Pkwy.
Herriman, UT Max LaRou
UT-412
65 P.S.I
PRM
0 79
15 77.5 -1.5 0.0055 0.0222
30 76.75 -0.75 0.0027 0.0108
PASS
DSL
0 66
15 64.5 -1.5 0.0055 0.0222
30 63.75 -0.75 0.0027 0.0108
PASS
12/15/2023
Max LaRou
UT-412
pei.org 49
Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities
APPENDIX C-9
MECHANICAL AND ELECTRONIC LINE LEAK DETECTORS
PERFORMANCE TEST
)DFLOLW\1DPH2ZQHU
$GGUHVV$GGUHVV
&LW\6WDWH=LS&RGH&LW\6WDWH=LS&RGH
)DFLOLW\,'3KRQH
7HVWLQJ&RPSDQ\3KRQH'DWH
7KLVGDWDVKHHWFDQEHXVHGWRWHVWPHFKDQLFDOOLQHOHDNGHWHFWRUV0//'DQGHOHFWURQLFOLQHOHDNGHWHFWRUV(//'ZLWKVXEPHUVLEOH
WXUELQHSXPS673V\VWHPV6HH3(,536HFWLRQVDQGIRUWHVWSURFHGXUHV
/LQH1XPEHU
3URGXFW6WRUHG
/HDN'HWHFWRU0DQXIDFWXUHU
/HDN'HWHFWRU0RGHO
7\SHRI/HDN'HWHFWRU 0//'
(//'
0//'
(//'
0//'
(//'
0//'
(//'
0//'
(//'
0//'
(//'
MLLD (ALL PRESSURE MEASUREMENTS ARE MADE IN PSIG)
673)XOO2SHUDWLQJ3UHVVXUH
&KHFN9DOYH+ROGLQJ3UHVVXUH
/LQH5HVLOLHQF\POOLQHEOHHGEDFNYRO
XPHDVPHDVXUHGIURPFKHFNYDOYHKROG
LQJSUHVVXUHWR]HURSVLJ
6WHS7KURXJK7LPHLQ6HFRQGVWLPHWKH
0//'KHVLWDWHVDWPHWHULQJSUHVVXUH
EHIRUHJRLQJWRIXOORSHUDWLQJSUHVVXUH
DVPHDVXUHGIURPSVLJZLWKQROHDN
LQGXFHGRQWKHOLQH
0HWHULQJ3UHVVXUH673SUHVVXUHZKHQ
VLPXODWHGOHDNUDWHJSKDWSVLJ
2SHQLQJ7LPHLQ6HFRQGVWKHWLPHWKH
0//'RSHQVWRDOORZIXOOSUHVVXUHDIWHU
VLPXODWHGOHDNLVVWRSSHG
'RHVWKH673SUHVVXUHUHPDLQDWRU
EHORZWKHPHWHULQJSUHVVXUHIRUDWOHDVW
VHFRQGVZKHQWKHVLPXODWHGOHDNLV
LQGXFHG"
<HV1R<HV1R <HV1R <HV1R <HV1R <HV1R
'RHVWKHOHDNGHWHFWRUUHVHWWULSZKHQ
WKHOLQHSUHVVXUHLVEOHGRIIWR]HURSVLJ"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
'RHVWKH673SURSHUO\F\FOHRQRIIXQGHU
QRUPDOIXHOV\VWHPRSHUDWLRQFRQGLWLRQV"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
$´1RµDQVZHUWRHLWKHURIWKHDERYHTXHVWLRQVLQGLFDWHVWKH0//'IDLOVWKHWHVW
ELLD (ALL PRESSURE MEASUREMENTS ARE MADE IN PSIG)
673)XOO2SHUDWLQJ3UHVVXUH
+RZPDQ\WHVWF\FOHVDUHREVHUYHG
EHIRUHDODUPVKXWGRZQRFFXUV"
'RHVWKHVLPXODWHGOHDNFDXVHDQDODUP"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
$´1RµDQVZHUWRWKHDERYHTXHVWLRQLQGL
FDWHVWKH(//'IDLOVWKHWHVW
'RHVWKHVLPXODWHGOHDNFDXVHDQ673
VKXWGRZQ"
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
Test Results 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO
Comments:
7HVWHU·V1DPH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 7HVWHU·V6LJQDWXUHBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 
Precision Testing Technologies Inc.801-886-9224
Sam’s Club #7168
13352 S. Fort Herriman Pkwy.
Herriman, UT
12/15/2023
3
PRM
V.R.
PLLD
4
43
2
4
4
4
4
DSL
V.R.
PLLD
4
46
2
4
4
4
Max LaRou UT-412
pei.org 45
Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities
APPENDIX C-5
7HVWHU·V1DPHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 7HVWHU·V6LJQDWXUHBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
UST OVERFILL EQUIPMENT INSPECTION
AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE
)DFLOLW\1DPH2ZQHU
$GGUHVV$GGUHVV
&LW\6WDWH=LS&RGH&LW\6WDWH=LS&RGH
)DFLOLW\,'3KRQH
7HVWLQJ&RPSDQ\3KRQH'DWH
7KLVGDWDVKHHWLVIRULQVSHFWLQJDXWRPDWLFVKXWRIIGHYLFHVDQGEDOOIORDWYDOYHV6HH3(,536HFWLRQIRULQVSHFWLRQSURFHGXUHV
3URGXFW*UDGH
7DQN1XPEHU
7DQN9ROXPHJDOORQV
7DQN'LDPHWHULQFKHV
2YHUILOO3UHYHQWLRQ'HYLFH%UDQG
7\SH $XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
$XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
$XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
$XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
$XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
$XWRPDWLF
6KXWRII'HYLFH
%DOO)ORDW
9DOYH
AUTOMATIC SHUTOFF DEVICE INSPECTION
'URSWXEHUHPRYHGIURPWDQN"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
'URSWXEHDQGIORDWPHFKD
QLVPVDUHIUHHRIGHEULV"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
)ORDWPRYHVIUHHO\ZLWKRXW
ELQGLQJDQGSRSSHWPRYHVLQWR
IORZSDWK"
<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
%\SDVVYDOYHLQWKHGURSWXEH
LVRSHQDQGIUHHRIEORFNDJHLI
SUHVHQW"
<HV1R
1RW3UHVHQW
<HV1R
1RW3UHVHQW
<HV1R
1RW3UHVHQW
<HV1R
1RW3UHVHQW
<HV1R
1RW3UHVHQW
<HV1R
1RW3UHVHQW
)ODSSHULVDGMXVWHGWRVKXWRII
IORZDWFDSDFLW\"
<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
$´1RµWRDQ\LWHPLQ/LQHVLQGLFDWHVDWHVWIDLOXUH
BALL FLOAT VALVE INSPECTION
7DQNWRSILWWLQJVDUHYDSRU
WLJKWDQGOHDNIUHH"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
%DOOIORDWFDJHIUHHRIGHEULV"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
%DOOLVIUHHRIKROHVDQGFUDFNV
DQGPRYHVIUHHO\LQFDJH"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
9HQWKROHLQSLSHLVRSHQDQG
QHDUWRSRIWDQN"<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
%DOOIORDWSLSHLVSURSHU
OHQJWKWRUHVWULFWIORZDW
FDSDFLW\"

<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
$´1RµWRDQ\LWHPLQ/LQHVLQGLFDWHVDWHVWIDLOXUH
Test Results 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO 3DVV)DLO

8VHPDQXIDFWXUHU·VVXJJHVWHGSURFHGXUHIRUGHWHUPLQLQJLIDXWRPDWLFVKXWRIIGHYLFHZLOOVKXWRIIIORZDWFDSDFLW\


8VHPDQXIDFWXUHU·VVXJJHVWHGSURFHGXUHIRUGHWHUPLQLQJLIIORZUHVWULFWLRQGHYLFHZLOOUHVWULFWIORZDWFDSDFLW\
Comments:
Precision Testing Technologies Inc.801-886-9224
Sam’s Club #7168
12/15/23
REG
1
19,782
118.4"
OPW
4
4
4
4
4
4
4
REG
2
11,904
118.4"
OPW
4
4
4
4
4
4
4
PRM
3
7,901
118.4"
OPW
4
4
4
4
4
4
4
Max LaRou UT-412
Sam's Club #7168Sam's Club #7168
PE
I
/
R
P
1
2
0
0
-
1
2
pe
i
.
o
r
g
50
A
P
P
E
N
D
I
X

C
-
1
0
SHEAR VALVE OPERATION INSPECTION
)DFLOLW\1DPH2ZQHU
$GGUHVV$GGUHVV
&LW\6WDWH=LS&RGH&LW\6WDWH=LS&RGH
)DFLOLW\,'3KRQH
7HVWLQJ&RPSDQ\3KRQH
7KLVGDWDVKHHWLVIRULQVSHFWLQJVKHDUYDOYHVORFDWHGLQVLGHGLVSHQVHUV6HH3(,536HFWLRQIRUWKHLQVSHFWLRQSURFHGXUH
3URGXFW*UDGH
'LVSHQVHU,'    
6KHDU9DOYH7\SH3URGXFW9DSRU
,VWKHVKHDUYDOYHULJLGO\
DQFKRUHGWRWKHGLVSHQVHUER[
IUDPHRUGLVSHQVHULVODQG"
<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
,VWKHVKHDUVHFWLRQSRVL
WLRQHGEHWZHHQóLQFKDERYH
RUEHORZWKHWRSVXUIDFHRIWKH
GLVSHQVHULVODQG"
<HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R <HV1R
,VWKHOHYHUDUPIUHHWRPRYH"<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
'RHVWKHOHYHUDUPVQDSVKXW
WKHSRSSHWYDOYH"
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
&DQDQ\SURGXFWEHGLVSHQVHG
ZKHQWKHSURGXFWVKHDUYDOYHLV
FORVHG"
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
<HV1R
1$
$´1RµWR/LQHVRUD´<HVµIRU/LQHLQGLFDWHVDWHVWIDLOXUH
Test Results 3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
3DVV
)DLO
Comments:
7HVWHU·V1aPH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB  7HVWHU·V6LJQDWXUH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB
Precision Testing Technologies, Inc. 801-886-9224 Date:
Sam’s Club #7168
PRM
1/2-11/12
P
4
4
4
4
4
4
DSL
1/2 3/4
9/10 11/12
P
4
4
4
4
4
4
Max LaRou UT-412
12/15/2023

FORM 1
SUMMARY OF SOURCE TEST DATA
SOURCE INFORMATION FACILITY PARAMETERS
GDF Name and addresss GDF Representative and Title
_________________________________
PHASE II SYSTEM TYPE
(Check One)
Balance ____
Hirt ____
Red Jacket ____
Hasstech ____ Healy ____Other
GDF Phone No. (___)________________
Permit Conditions Source: GDF Vapor Recovery System
GDF #
A/C # Manifolded? Y or N
Operating Parameters
Number of Nozzles Served by Tank #1 ______ Number of Nozzles Served by Tank #3 ______
Number of Nozzles Served by Tank #2 ______ Number of Nozzles Served by Tank #4 ______
Applicable Regulations: VN Recommended
Source Test Results and Comments
Tank #:
1.Product Grade
2.Actual Tank Capacity, gallons
3.Gasoline Volume
4.Ullage, gallons (#2-#3)
5.Initial Pressure, inches H 2 O
6.Pressure After 1 Minute, inches H 2 O
7.Pressure After 2 Minutes, inches H 2 O
8.Pressure After 3 Minutes, inches H 2 O
9.Pressure After 4 Minutes, inches H 2 O
10.Final Pressure After 5 Minutes, inches H 2 O
11.Allowable Final Pressure
Test Conducted by: Test Company: Date of Test:
California Air Resources Board July 26, 2012
TP-201.3, Page 14
40CFR63CCCCCC
Precision Testing Technologies
Sams Club #7168
13352 S. Herriman Pkwy.
Herriman, UT
V.R.S. Dual Point
4
1
REG
19,782
13,212
2
REG
11,904
9,415
3
PRM
7,901
3,896
13,064
N.A.
"
"
"
"
"
1.90
Max LaRou UT-412 12/15/2023
Sams Club #7168
13352 S. Herriman Pkwy.
Pressure/Vacuum (P/V) Vent Valve Data Sheet
Facility Name: Test Date:
Address: Test Company: Precision Testing Technologies
City: Tester Name:
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
Product:
P/V Valve Manufacturer: Model Number: Pass Fail
Manufacturers Specified
Positive Leak Rate (CFH):
Manufacturers Specified
Negative Leak Rate (CFH):
Measured Positive Leak Rate (CFH): Measured Negative Leak Rate (CFH):
Positive Cracking Pressure (in H2O): Negative Cracking Pressure (in H2O):
2.5" to 6" wc
<=0.05 cfh @ 2" wc
2.5" to 6" wc
<=0.05 cfh @2" wc
2.5" to 6" wc
<=0.05 cfh 2" wc
2.5" to 6" wc
<=0.05 cfh 2" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
6" to 10" wc
<=0.21 cfh @ 4" wc
Sam's Club #7168
13352 S. Herriman Pkwy.
Herriman, UT
12/15/2023
Max LaRou UT-412
REG1, REG2, PRM
Husky 4885 4
0.03 cfh @ 2"wc
2.9"wc
0.19 cfh @ 4"wc
-7.8"wc
Sam's Club #7168
13352 S. Herriman Pkwy.
Max LaRou UT-412
12/15/2023
Herriman, UT
California Air Resources Board October 8, 2003
TP-201.1B, Page 5
Form 1
Static Torque of Rotatable Phase I Adaptors
Measurement Units: (Check Box): pound-inches pound-feet
Vapor Adaptor 1 Vapor Adaptor 2 Vapor Adaptor 3 Vapor Adaptor 4
Brand:Brand:Brand:Brand:
Model:Model:Model:Model:
Grade:Grade:Grade:Grade:
Torque 1:Torque 1:Torque 1:Torque 1:
Torque 2:Torque 2:Torque 2:Torque 2:
Torque 3:Torque 3:Torque 3:Torque 3:
Average:Average:Average:Average:
360 Rotation:360 Rotation: 360 Rotation:360 Rotation:
Product Adaptor 1 Product Adaptor 2 Product Adaptor 3 Product Adaptor 4
Brand:Brand:Brand:Brand:
Model:Model:Model:Model:
Grade:Grade:Grade:Grade:
Torque 1:Torque 1:Torque 1:Torque 1:
Torque 2:Torque 2:Torque 2:Torque 2:
Torque 3:Torque 3:Torque 3:Torque 3:
Average:Average:Average:Average:
360 Rotation: 360 Rotation: 360 Rotation:360 Rotation:
Comments: ___________________________________________________________________
Test Company:Conducted By:
Test Date:Facility Name:
Facility Address:City:
Precision Testing Technologies Max LaRou
12/15/2023 Max LaRou
13352 S. Herriman Pkwy.Herriman, UT
4
OPW
61VRS
REG 1
145
140
135
140
Yes
OPW
61SALP
REG 1
160
160
160
160
Yes
OPW
61VRS
REG 2
125
120
115
120
Yes
OPW
61SALP
REG 2
125
100
100
108
Yes
OPW
61VRS
PRM
160
145
145
150
Yes
OPW
61SALP
PRM
135
135
125
131
Yes
Yes
Yes