DERR-2024-005570

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: 3/28/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 3/5/2024
Order Number: 2365039
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN 38851
5696 W 3500 S
State ID 4002586
West Valley, UT 84128
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN 38851
5696 W 3500 S State ID 4002586
West Valley UT 84128
38851
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
03/05/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000
Vaporless LD-
2000LD2000LD2000LD2000
30
30
150
2
20
3
30
30
150
2
20
3
30
30
100
2
20
3
UT151
David Mathie
NW1-2365039
Low Sulfur Diesel
TTNK1:1 TTNK2:1 TTNK3:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2365039 Date:3/5/2024
Site Name/ID:7-ELEVEN 38851
Address:5696 W 3500 S State ID 4002586
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 85 Pass Fail Not Tested
1/2 91 Pass Fail Not Tested
3/4 40 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 85 Pass Fail Not Tested
9/10 91 Pass Fail Not Tested
11/12 40 Pass Fail Not Tested
11/12 85 Pass Fail Not Tested
11/12 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 38851 7-ELEVEN, INC.
5696 W 3500 S State ID 4002586
West Valley UT 84128
4002586
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 03/05/2024
1 2 3
RUL PUL DSL
VR350 VR350 VR350
19782 7901 11904
118.38 118.38 118.38
UT151
David Mathie
5696 W 3500 S State ID 4002586
7-ELEVEN 38851
5696 W 3500 S State ID 4002586, West Valley, UT 84128
38851
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/05/2024
ANNULAR ANNULAR SB FILL STP SB FILL STP SB FILL
RUL PUL/DSL RUL RUL PUL PUL DSL
UT151
David Mathie
5696 W 3500 S State ID 4002586
7-ELEVEN 38851
5696 W 3500 S State ID 4002586, West Valley, UT 84128
38851
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/05/2024
STP UDC UDC UDC UDC UDC UDC
DSL 1/2 3/4 5/6 7/8 9/10 11/12
UT151
David Mathie
2 inch Pressure Decay Test
TP201.3

Store Information Testing Company
Site Name :7-ELEVEN 38851 Name :TANKNOLOGY INC.
Address :5696 W 3500 S State ID 4002586
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 :12
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
14421
5361

13:30
2.00
1.98
1.96
1.95
1.94
1.93
1.83
Pass
TNK2
PUL
7901
5609
2292

13:38
2.00
1.96
1.93
1.90
1.88
1.86
1.61
Pass

Total

27683
20030
7653
All

Comments:

Tester :David Mathie Test Date :3/5/2024
Signature :Work Order :2365039

WO: 2365039
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 22 0.0466 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 2.02 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -3.03 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 3.64 Pass
Neg Leak Rate (CFH)0.21 17 0.0360 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -6.85 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 1.88 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -2.66 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 3.71 Pass
Neg Leak Rate (CFH)0.21 15 0.0318 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.16 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: 0.0678

Test Date 3/5/2024
Technician Name David Mathie
WO #2365039
Facility Name / Loc #7-ELEVEN 38851 38851
Street 5696 W 3500 S State ID 4002586
City, St, Zip West Valley, UT 84128

Pressure Vacuum Vent Cap Test Form TP-201.1E

7-ELEVEN 38851
5696 W 3500 S State ID 4002586
West Valley, UT 84128
38851
Tanknology, Inc.
7-ELEVEN, INC.
972-828-7575
800-800-4633 03/05/2024
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
56
161
19782
103
19782
18365
92.8
Site ID/ Name:
Address:
38851 7-ELEVEN 38851 NW1-2365039 03/05/2024
5696 W 3500 S State ID 4002586, West Valley, UT
84128
Tank ID:TNK1(RUL)
59.5
165.75
7901
104.25
7901
7367
93.2
Site ID/ Name:
Address:
38851 7-ELEVEN 38851 NW1-2365039 03/05/2024
5696 W 3500 S State ID 4002586, West Valley, UT
84128
Tank ID:TNK2(PUL)
63
168
11904
103
11904
11090
93.1
Site ID/ Name:
Address:
38851 7-ELEVEN 38851 NW1-2365039 03/05/2024
5696 W 3500 S State ID 4002586, West Valley, UT
84128
Tank ID:TNK3(Low Sulfur Diesel)
Tank ID:
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2365039
Site ID / Name:38851 / 7-ELEVEN 38851
Address:5696 W 3500 S State ID 4002586
City:West Valley State:UT Zip:84128
W.O.# NW1-2365039
+AAE-
I10100
MAR 5, 2024 2:04 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I90200
MAR 5, 2024 2:04 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-
I11B09
MAR 5, 2024 2:04 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
SERVICE NOTICE SESSION REPORT
START TIME END TIME
MAR 5, 2024 12:08 PM MAR 5, 2024 2:00 PM
JAN 22, 2024 8:44 AM JAN 22, 2024 10:47 AM
MAR 6, 2023 9:52 AM MAR 6, 2023 11:31 AM
MAR 21, 2022 9:23 AM MAR 21, 2022 10:51 AM
+AAMAAQ-
I20100
MAR 5, 2024 2:04 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP
1 REGULAR 14421 14505 5361 77.90 0.00 51.68
2 PREMIUM 5609 5647 1574 82.38 0.00 50.12
3 DIESEL 5818 5836 6086 58.24 0.00 53.17
+AAMAAQ-
I30100
MAR 5, 2024 2:04 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 RUL ANNULAR SENSOR NORMAL
2 PUL-DSL ANNULAR SENSOR NORMAL
3 RUL SPILL BCKT SENSOR NORMAL
4 RUL STP SENSOR NORMAL
5 PUL SPILL BCKT SENSOR NORMAL
6 ?UL STP SENSOR NORMAL
7 DSL SPILL BCKT 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
14 DISP 11-12 SENSOR NORMAL
+AAMAAQ-9999FF1B+AAMAAQ-
I30200
MAR 5, 2024 2:05 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 RUL ANNULAR
MAR 5, 2024 12:55 PM FUEL ALARM
MAR 5, 2024 12:55 PM FUEL ALARM
MAR 6, 2023 10:54 AM FUEL ALARM
2 PUL-DSL ANNULAR
MAR 5, 2024 12:58 PM FUEL ALARM
MAR 6, 2023 11:14 AM FUEL ALARM
MAR 21, 2022 10:09 AM FUEL ALARM
3 RUL SPILL BCKT
MAR 5, 2024 12:41 PM FUEL ALARM
MAR 6, 2023 11:00 AM FUEL ALARM
MAR 21, 2022 10:25 AM FUEL ALARM
4 RUL STP
MAR 5, 2024 12:29 PM FUEL ALARM
MAR 6, 2023 10:34 AM FUEL ALARM
MAR 21, 2022 10:27 AM FUEL ALARM
5 PUL SPILL BCKT
MAR 5, 2024 12:46 PM FUEL ALARM
MAR 6, 2023 11:06 AM FUEL ALARM
MAR 21, 2022 10:36 AM FUEL ALARM
6 ?UL STP
MAR 5, 2024 12:32 PM FUEL ALARM
MAR 5, 2024 12:32 PM FUEL ALARM
MAR 6, 2023 10:40 AM FUEL ALARM
7 DSL SPILL BCKT
MAR 5, 2024 12:52 PM FUEL ALARM
MAR 6, 2023 11:11 AM FUEL ALARM
MAR 21, 2022 10:43 AM FUEL ALARM
8 DSL STP
MAR 5, 2024 12:36 PM FUEL ALARM
JAN 22, 2024 9:06 AM FUEL ALARM
MAR 6, 2023 10:45 AM FUEL ALARM
9 DISP 1-2
MAR 5, 2024 1:03 PM FUEL ALARM
MAR 6, 2023 10:01 AM FUEL ALARM
MAR 21, 2022 9:51 AM FUEL ALARM
10 DISP 3-4
MAR 5, 2024 1:04 PM FUEL ALARM
MAR 6, 2023 10:01 AM FUEL ALARM
MAR 21, 2022 9:51 AM FUEL ALARM
11 DISP 5-6
MAR 5, 2024 1:06 PM FUEL ALARM
MAR 6, 2023 10:02 AM FUEL ALARM
MAR 21, 2022 9:53 AM FUEL ALARM
12 DISP 7-8
MAR 5, 2024 1:05 PM FUEL ALARM
MAR 6, 2023 10:03 AM FUEL ALARM
MAR 21, 2022 9:53 AM FUEL ALARM
13 DISP 9-10
MAR 5, 2024 1:07 PM FUEL ALARM
MAR 6, 2023 10:03 AM FUEL ALARM
MAR 21, 2022 9:53 AM FUEL ALARM
14 DISP 11-12
MAR 5, 2024 1:17 PM FUEL ALARM
MAR 6, 2023 10:04 AM FUEL ALARM
MAR 21, 2022 9:53 AM FUEL ALARM
+AAMAAQ-
IA0100
MAR 5, 2024 2:05 PM
TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 1 REGULAR MAG D004 126.00 413292 4604
TANK 2 PREMIUM MAG D004 126.00 404677 4104
TANK 3 DIESEL MAG D004 126.00 413291 4604
+AAMAAQ-
931
TANK 1 SETUP CONDITIONS
PRODUCT: REGULAR
PRODUCT CODE 1
HIGH WATER LIMIT 0.8
OVERFILL LIMIT: 17803
HIGH PRODUCT LIMIT: 18792
LOW PRODUCT: 1504
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF: 0.000700
DELIVERY DELAY: 5
TANK FULL CAPACITY: 19782 0 0 0 0
3/4 HEIGHT CAPACITY: 16055 0 0 0 0
1/2 HEIGHT CAPACITY: 9897 0 0 0 0
1/4 HEIGHT CAPACITY: 3718 0 0 0 0
TANK DIAMETER: 118.33
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
932
TANK 2 SETUP CONDITIONS
PRODUCT: PREMIUM
PRODUCT CODE 2
HIGH WATER LIMIT 0.8
OVERFILL LIMIT: 7110
HIGH PRODUCT LIMIT: 7505
LOW PRODUCT: 651
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF: 0.000700
DELIVERY DELAY: 5
TANK FULL CAPACITY: 7901 0 0 0 0
3/4 HEIGHT CAPACITY: 6365 0 0 0 0
1/2 HEIGHT CAPACITY: 3964 0 0 0 0
1/4 HEIGHT CAPACITY: 1551 0 0 0 0
TANK DIAMETER: 118.33
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
933
TANK 3 SETUP CONDITIONS
PRODUCT: DIESEL
PRODUCT CODE 3
HIGH WATER LIMIT 0.8
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: 9710 0 0 0 0
1/2 HEIGHT CAPACITY: 5944 0 0 0 0
1/4 HEIGHT CAPACITY: 2172 0 0 0 0
TANK DIAMETER: 118.33
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
MAR 5, 2024 2:05 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
MAR 5, 2024 2:05 PM
LIQUID TYPE
SENSOR LOCATION TYPE
1 RUL ANNULAR TRI-STATE (SINGLE FLOAT)
2 PUL-DSL ANNULAR TRI-STATE (SINGLE FLOAT)
3 RUL SPILL BCKT NORMALLY CLOSED
4 RUL STP TRI-STATE (SINGLE FLOAT)
5 PUL SPILL BCKT NORMALLY CLOSED
6 ?UL STP TRI-STATE (SINGLE FLOAT)
7 DSL SPILL BCKT 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 DISP 11-12 TRI-STATE (SINGLE FLOAT)
15 TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE FLOAT)
+AAMAAQ-
I80800
MAR 5, 2024 2:05 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
MAR 5, 2024 2:05 PM
871677 7-11 38851
5696 W 3500 S
SALT LAKE CITY UT
V10274571805001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 4 PROBE / G.T. 162098 161995
2 INTERSTITIAL BD 200592 200235
3 INTERSTITIAL BD 200285 200045
4 UNUSED 9545870 9365682
5 UNUSED 9535659 9347002
6 UNUSED 9529500 9347978
7 UNUSED 9533553 9344483
8 UNUSED 9529817 9340896
9 RELAY BOARD 14999 15006
10 UNUSED 9537858 9347207
11 UNUSED 9529141 9344234
12 UNUSED 9530432 9341465
13 UNUSED 9529119 9341896
14 UNUSED 9528983 9339535
15 UNUSED 9531428 9340035
16 UNUSED 9531360 9342849
COMM 1 ELEC DISP INT. 101492 101297
COMM 2 ELEC DISP INT. 101030 100880
COMM 3 SERIAL SAT BD 480638 479043
COMM 4 UNUSED 9544990 9353063
COMM 5 RS485 SERIAL BD 68467 68318
COMM 6 MT COMM BOARD 406133 405578
+AAM-