DERR-2024-005390

IMPACT VALVE
LEAK DETECTOR
MONITOR CERTIFICATION
OVERFILL OPERABILITY
PV VENT CAP
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 3/25/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 3/19/2024
Order Number: 2365045
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN 34740
4090 S. RIVERDALE
State ID 1200019
RIVERDALE, UT 84405
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN 34740
4090 S. RIVERDALE State ID 1200019
RIVERDALE UT 84405
34740
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
03/19/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000LD2000LD2000
30
30
150
2
20
3
30
30
150
2
20
3
UT151
David Mathie
NW1-2365045
TTNK1:1 TTNK2:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2365045 Date:3/19/2024
Site Name/ID:7-ELEVEN 34740
Address:4090 S. RIVERDALE State ID 1200019
City:RIVERDALE State:UT Zip:84405
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
7/8 85 Pass Fail Not Tested
7/8 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 34740 7-ELEVEN, INC.
4090 S. RIVERDALE State ID 1200019
RIVERDALE UT 84405
1200019
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 03/19/2024
1 2
RUL PUL
VR 350 VR 350
14881 9753
90.5 90.5
UT151
David Mathie
4090 S. RIVERDALE State ID 1200019
7-ELEVEN 34740
4090 S. RIVERDALE State ID 1200019, RIVERDALE, UT 84405
34740
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/19/2024
ANNULAR ANNULAR STP STP UDC UDC UDC
'RUL PUL RUL PUL 1/2 3/4 5/6
UT151
David Mathie
4090 S. RIVERDALE State ID 1200019
7-ELEVEN 34740
4090 S. RIVERDALE State ID 1200019, RIVERDALE, UT 84405
34740
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/19/2024
UDC
7/8
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 0.08 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -0.19 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 3.62 Pass
Neg Leak Rate (CFH)0.21 17 0.0360 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -6.92 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 11.00 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -0.23 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 8 0.0170 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.55 Pass
Neg Leak Rate (CFH)0.21 19 0.0403 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -6.81 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: 0.0297
Total -ve LR: 0.0763

Test Date 3/19/2024
Technician Name David Mathie
WO #2365045
Facility Name / Loc #7-ELEVEN 34740 34740
Street 4090 S. RIVERDALE State ID 1200019
City, St, Zip RIVERDALE, UT 84405

Pressure Vacuum Vent Cap Test Form TP-201.1E

7-ELEVEN 34740
4090 S. RIVERDALE State ID 1200019
RIVERDALE , UT 84405
34740
Tanknology, Inc.
7-ELEVEN, INC.
972-828-7575
800-800-4633 03/19/2024
RUL
1
14881
90.5
OPW
PUL
2
9753
90.5
OPW
UT151
David Mathie
P.O. BOX 711
DALLAS, TX 75221
63.75
146.75
14881
81
14079
14881
94.6
Site ID/ Name:
Address:
34740 7-ELEVEN 34740 NW1-2365045 03/19/2024
4090 S. RIVERDALE State ID 1200019, RIVERDALE,
UT 84405
Tank ID:TNK1(RUL)
58.5
141.5
9753
81
9243
9753
94.8
Site ID/ Name:
Address:
34740 7-ELEVEN 34740 NW1-2365045 03/19/2024
4090 S. RIVERDALE State ID 1200019, RIVERDALE,
UT 84405
Tank ID:TNK2(PUL)
Tank ID:
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2365045
Site ID / Name:34740 / 7-ELEVEN 34740
Address:4090 S. RIVERDALE State ID 1200019
City:RIVERDALE State:UT Zip:84405
W.O.# NW1-2365045
+AAE-
I10100
MAR 19, 2024 10:37 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I90200
MAR 19, 2024 10:37 AM
SOFTWARE REVISION LEVEL
VERSION 331.00
SOFTWARE+ACM- 346331-100-A
CREATED - 11.02.10.12.31
S-MODULE+ACM- 330160-100-a
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
BIR
+AAMAAQ-
I11B00
MAR 19, 2024 10:38 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
SERVICE NOTICE SESSION REPORT
START TIME END TIME
MAR 19, 2024 9:36 AM MAR 19, 2024 10:34 AM
MAR 28, 2023 9:48 AM MAR 28, 2023 10:30 AM
APR 4, 2022 9:54 AM APR 4, 2022 10:48 AM
APR 21, 2021 9:09 AM APR 21, 2021 10:31 AM
APR 21, 2020 9:45 AM APR 21, 2020 10:45 AM
APR 26, 2019 9:04 AM APR 26, 2019 9:51 AM
APR 30, 2018 10:18 AM APR 30, 2018 11:06 AM
MAY 9, 2017 10:09 AM MAY 9, 2017 10:44 AM
MAY 10, 2016 9:54 AM MAY 10, 2016 11:00 AM
MAY 21, 2015 9:54 AM MAY 21, 2015 10:40 AM
+AAMAAQ-
I20100
MAR 19, 2024 10:38 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP
1 RUL 2711 2726 12170 21.74 0.00 52.21
2 PUL 5048 5074 4705 46.39 0.00 52.43
+AAMAAQ-
I30100
MAR 19, 2024 10:38 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 DISP 1-2 SENSOR NORMAL
2 DISP 3-4 SENSOR NORMAL
3 DISP 5-6 SENSOR NORMAL
4 DISP 7-8 SENSOR NORMAL
9 UNLD INTERSTITIAL SENSOR NORMAL
11 UNLD STP SUMP SENSOR NORMAL
13 PREM INTERSTITIAL SENSOR NORMAL
15 PREM STP SUMP SENSOR NORMAL
+AAMAAQ-
I30200
MAR 19, 2024 10:38 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 DISP 1-2
MAR 19, 2024 10:10 AM FUEL ALARM
MAR 28, 2023 9:54 AM FUEL ALARM
APR 4, 2022 9:56 AM FUEL ALARM
2 DISP 3-4
MAR 19, 2024 10:12 AM FUEL ALARM
MAR 28, 2023 9:54 AM FUEL ALARM
APR 4, 2022 9:57 AM FUEL ALARM
3 DISP 5-6
MAR 19, 2024 10:13 AM FUEL ALARM
MAR 28, 2023 9:54 AM FUEL ALARM
APR 4, 2022 9:57 AM FUEL ALARM
4 DISP 7-8
MAR 19, 2024 10:13 AM FUEL ALARM
MAR 28, 2023 9:53 AM FUEL ALARM
APR 4, 2022 9:57 AM FUEL ALARM
9 UNLD INTERSTITIAL
MAR 19, 2024 9:48 AM FUEL ALARM
MAR 28, 2023 10:13 AM FUEL ALARM
APR 4, 2022 10:05 AM FUEL ALARM
11 UNLD STP SUMP
MAR 19, 2024 9:40 AM FUEL ALARM
MAR 28, 2023 10:25 AM FUEL ALARM
MAR 28, 2023 10:24 AM FUEL ALARM
13 PREM INTERSTITIAL
MAR 19, 2024 9:54 AM FUEL ALARM
MAR 28, 2023 10:14 AM FUEL ALARM
APR 4, 2022 10:07 AM FUEL ALARM
15 PREM STP SUMP
MAR 19, 2024 9:42 AM FUEL ALARM
SEP 20, 2023 3:04 PM FUEL ALARM
MAR 28, 2023 10:27 AM FUEL ALARM
+AAMAAQ-
IA0100
MAR 19, 2024 10:38 AM
TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 1 RUL MAG D004 96.00 580545 1214
TANK 2 PUL MAG D004 96.00 580546 1214
+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: 99
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 3
TANK FULL CAPACITY: 14881 14614 14126 13518 12812
3/4 HEIGHT CAPACITY: 12029 11187 10298 9376 8432
1/2 HEIGHT CAPACITY: 7451 6495 5551 4653 3713
1/4 HEIGHT CAPACITY: 2869 2086 1378 753 276
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: 99
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 3
TANK FULL CAPACITY: 9753 9585 9272 8879 8420
3/4 HEIGHT CAPACITY: 7907 7353 6767 6158 5533
1/2 HEIGHT CAPACITY: 4883 4268 3625 3032 2412
1/4 HEIGHT CAPACITY: 1858 1344 883 479 174
TANK DIAMETER: 90.50
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-9999FF1B+AAMAAQ-
I61100
MAR 19, 2024 10:38 AM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
AUG 19, 2011
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 3 HOURS
TST EARLY STOP:DISABLED
+AAMAAQ-
I70300
MAR 19, 2024 10:38 AM
LIQUID TYPE
SENSOR LOCATION TYPE
1 DISP 1-2 TRI-STATE (SINGLE FLOAT)
2 DISP 3-4 TRI-STATE (SINGLE FLOAT)
3 DISP 5-6 TRI-STATE (SINGLE FLOAT)
4 DISP 7-8 TRI-STATE (SINGLE FLOAT)
5 TRI-STATE (SINGLE FLOAT)
6 TRI-STATE (SINGLE FLOAT)
7 TRI-STATE (SINGLE FLOAT)
8 TRI-STATE (SINGLE FLOAT)
9 UNLD INTERSTITIAL TRI-STATE (SINGLE FLOAT)
10 UNLD FILL SUMP TRI-STATE (SINGLE FLOAT)
11 UNLD STP SUMP TRI-STATE (SINGLE FLOAT)
12 TRI-STATE (SINGLE FLOAT)
13 PREM INTERSTITIAL TRI-STATE (SINGLE FLOAT)
14 PREM FILL SUMP TRI-STATE (SINGLE FLOAT)
15 PREM STP SUMP TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE FLOAT)
+AAMAAQ-
I80800
MAR 19, 2024 10:38 AM
+AAMAAQ-
I10200
MAR 19, 2024 10:38 AM
293303 7-11 34740
4060 S. RIVERDALE RD
RIVERDALE, UTAH
LO3211752705001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 INTERSTITIAL BD 201963 201893
2 INTERSTITIAL BD 201255 201335
3 4 PROBE / G.T. 163900 163977
4 UNUSED 8898953 9319357
5 UNUSED 8886876 9306348
6 UNUSED 8881067 9313298
7 UNUSED 8885587 9312051
8 UNUSED 8882333 9315303
9 UNUSED 8884032 9311870
10 UNUSED 8883639 9313830
11 UNUSED 8881281 9319689
12 UNUSED 8880975 9309576
13 UNUSED 8880560 9310043
14 UNUSED 8883661 9314632
15 UNUSED 8879621 9305098
16 UNUSED 8880691 9315055
COMM 1 ELEC DISP INT. 100786 100771
COMM 2 UNUSED 101412 9314721
COMM 3 SERIAL SAT BD 483751 484981
COMM 4 UNUSED 8889798 9315122
COMM 5 RS485 SERIAL BD 68736 68813
COMM 6 MT COMM BOARD 412001 412407
+AAM-