DERR-2024-005477

IMPACT VALVE
LEAK DETECTOR
MONITOR CERTIFICATION
PV VENT CAP
11000 N. MoPac Expressway, Suite 500
Austin, Texas 78759
Phone: [phone]
Fax: [phone] Date Printed and Mailed: 3/30/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 3/6/2024
Order Number: 2365041
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-Eleven 36026
3694 W 11400 South
State ID 4002481
South Jordan, UT 84095
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-Eleven 36026
3694 W 11400 South State ID 4002481
South Jordan UT 84095
36026
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
03/06/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000
Vaporless LD-
2000LD2000LD2000LD2000
30
30
175
3
20
4
30
30
175
3
20
4
30
30
100
2
20
3
UT151
David Mathie
NW1-2365041
Low Sulfur Diesel
TTNK1 Regular:1 TTNK2 Premium:1 TTNK3 Diesel:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2365041 Date:3/6/2024
Site Name/ID:7-Eleven 36026
Address:3694 W 11400 South State ID 4002481
City:South Jordan State:UT Zip:84095
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 36026 7-ELEVEN, INC.
3694 W 11400 South State ID 4002481
South Jordan UT 84095
4002481
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 03/06/2024
1 2 3
RUL PUL DSL
VR350 VR350 VR350
19782 7901 11904
118.38 118.38 118.38
UT151
David Mathie
3694 W 11400 South State ID 4002481
7-Eleven 36026
3694 W 11400 South State ID 4002481, South Jordan, UT 84095
36026
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/06/2024
ANNULAR ANNULAR FILL STP FILL STP FILL
RUL PUL/DSL RUL RUL PUL PUL DSL
UT151
David Mathie
3694 W 11400 South State ID 4002481
7-Eleven 36026
3694 W 11400 South State ID 4002481, South Jordan, UT 84095
36026
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
03/06/2024
STP UDC UDC UDC UDC UDC UDC
DSL 1/2 3/4 5/6 7/8 9/10 11/12
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 1.72 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -2.04 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 7 0.0148 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 3.68 Pass
Neg Leak Rate (CFH)0.21 15 0.0318 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.04 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 1.01 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -1.54 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 3.70 Pass
Neg Leak Rate (CFH)0.21 16 0.0339 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -6.99 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: 0.0275
Total -ve LR: 0.0657

Test Date 3/6/2024
Technician Name David Mathie
WO #2365041
Facility Name / Loc #7-Eleven 36026 36026
Street 3694 W 11400 South State ID 4002481
City, St, Zip South Jordan, UT 84095

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:2365041
Site ID / Name:36026 / 7-Eleven 36026
Address:3694 W 11400 South State ID 4002481
City:South Jordan State:UT Zip:84095
W.O.# NW1-2365041
+AAE-
I10100
MAR 6, 2024 10:08 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-
I90200
MAR 6, 2024 10:08 AM
SOFTWARE REVISION LEVEL
VERSION 333.02
SOFTWARE+ACM- 346333-100-C
CREATED - 12.08.10.11.22
S-MODULE+ACM- 330160-100-a
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
BIR
+AAMAAQ-
I11B00
MAR 6, 2024 10:09 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
SERVICE NOTICE SESSION REPORT
START TIME END TIME
MAR 6, 2024 8:54 AM MAR 6, 2024 10:04 AM
MAR 13, 2023 9:12 AM MAR 13, 2023 10:43 AM
APR 6, 2022 11:59 AM APR 6, 2022 1:06 PM
APR 14, 2021 11:33 AM APR 14, 2021 12:53 PM
APR 14, 2020 11:12 AM APR 14, 2020 1:00 PM
MAY 10, 2019 9:27 AM MAY 10, 2019 9:44 AM
APR 16, 2019 9:00 AM APR 16, 2019 10:30 AM
APR 17, 2018 10:56 AM APR 17, 2018 12:26 PM
APR 25, 2017 9:37 AM APR 25, 2017 11:38 AM
APR 28, 2016 11:19 AM APR 28, 2016 12:52 PM
+AAMAAQ-
I20100
MAR 6, 2024 10:09 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP
1 UNLEADED 11185 11248 8597 65.13 0.00 51.83
2 PREMIUM 3282 3296 4619 51.13 0.00 53.66
3 DIESEL 3371 3380 8533 39.66 0.00 54.00
+AAMAAQ-
I30100
MAR 6, 2024 10:09 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 1,2 UDC SUMP SENSOR NORMAL
2 3,4 UDC SUMP SENSOR NORMAL
3 5,6 UDC SUMP SENSOR NORMAL
4 7,8 UDC SUMP SENSOR NORMAL
5 9,10 UDC SUMP SENSOR NORMAL
6 11,12 UDC SUMP SENSOR NORMAL
9 UNLEADED STP SUMP SENSOR NORMAL
10 UNLEADED FILL SUMP SENSOR NORMAL
11 PREMIUM STP SUMP SENSOR NORMAL
12 PREMIUM FILL SUMP SENSOR NORMAL
13 DIESEL STP SUMP SENSOR NORMAL
14 DIESEL FILL SUMP SENSOR NORMAL
15 UNLEADED ANNULAR SENSOR NORMAL
16 PREMIUM ANNULAR SENSOR NORMAL
+AAMAAQ-
I30200
MAR 6, 2024 10:09 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 1,2 UDC SUMP
MAR 6, 2024 9:00 AM FUEL ALARM
MAR 13, 2023 9:14 AM FUEL ALARM
APR 6, 2022 12:05 PM FUEL ALARM
2 3,4 UDC SUMP
MAR 6, 2024 9:00 AM FUEL ALARM
MAR 13, 2023 9:15 AM FUEL ALARM
APR 6, 2022 12:05 PM FUEL ALARM
3 5,6 UDC SUMP
MAR 6, 2024 9:01 AM FUEL ALARM
MAR 13, 2023 9:16 AM FUEL ALARM
APR 6, 2022 12:04 PM FUEL ALARM
4 7,8 UDC SUMP
MAR 6, 2024 9:01 AM FUEL ALARM
MAR 13, 2023 9:16 AM FUEL ALARM
APR 6, 2022 12:04 PM FUEL ALARM
5 9,10 UDC SUMP
MAR 6, 2024 9:10 AM FUEL ALARM
SEP 15, 2023 11:12 AM FUEL ALARM
MAR 13, 2023 9:50 AM FUEL ALARM
6 11,12 UDC SUMP
MAR 6, 2024 9:03 AM FUEL ALARM
MAR 13, 2023 9:18 AM FUEL ALARM
APR 6, 2022 12:03 PM FUEL ALARM
9 UNLEADED STP SUMP
MAR 6, 2024 9:31 AM FUEL ALARM
MAR 13, 2023 9:52 AM FUEL ALARM
APR 6, 2022 12:35 PM FUEL ALARM
10 UNLEADED FILL SUMP
MAR 6, 2024 9:31 AM FUEL ALARM
MAR 29, 2023 7:45 PM FUEL ALARM
MAR 24, 2023 11:03 AM FUEL ALARM
11 PREMIUM STP SUMP
MAR 6, 2024 9:32 AM FUEL ALARM
MAR 13, 2023 9:55 AM FUEL ALARM
APR 6, 2022 12:37 PM FUEL ALARM
12 PREMIUM FILL SUMP
MAR 6, 2024 9:32 AM FUEL ALARM
MAR 13, 2023 10:19 AM FUEL ALARM
APR 6, 2022 12:38 PM FUEL ALARM
13 DIESEL STP SUMP
MAR 6, 2024 9:34 AM FUEL ALARM
MAR 13, 2023 9:58 AM FUEL ALARM
APR 6, 2022 12:40 PM FUEL ALARM
14 DIESEL FILL SUMP
MAR 6, 2024 9:33 AM FUEL ALARM
MAR 13, 2023 10:21 AM FUEL ALARM
APR 6, 2022 12:41 PM FUEL ALARM
15 UNLEADED ANNULAR
MAR 6, 2024 9:29 AM FUEL ALARM
MAR 13, 2023 9:44 AM FUEL ALARM
APR 6, 2022 12:44 PM FUEL ALARM
16 PREMIUM ANNULAR
MAR 6, 2024 9:30 AM FUEL ALARM
MAR 13, 2023 9:46 AM FUEL ALARM
APR 6, 2022 12:45 PM FUEL ALARM
+AAMAAQ-
IA0100
MAR 6, 2024 10:09 AM
TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 1 UNLEADED MAG D004 126.00 713824 0034
TANK 2 PREMIUM MAG D004 126.00 713823 0034
TANK 3 DIESEL MAG D004 126.00 713825 0034
+AAMAAQ-
931
TANK 1 SETUP CONDITIONS
PRODUCT: UNLEADED
PRODUCT CODE 1
HIGH WATER LIMIT 1.5
OVERFILL LIMIT: 17803
HIGH PRODUCT LIMIT: 18792
LOW PRODUCT: 747
SUDDEN LOSS LIMIT: 25
LEAK LIMIT: 15
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 19782 0 0 0 0
3/4 HEIGHT CAPACITY: 16039 0 0 0 0
1/2 HEIGHT CAPACITY: 9883 0 0 0 0
1/4 HEIGHT CAPACITY: 3735 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: PREMIUM
PRODUCT CODE 2
HIGH WATER LIMIT 1.5
OVERFILL LIMIT: 7110
HIGH PRODUCT LIMIT: 7505
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: 6356 0 0 0 0
1/2 HEIGHT CAPACITY: 3964 0 0 0 0
1/4 HEIGHT CAPACITY: 1560 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: DIESEL
PRODUCT CODE 3
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: 9700 0 0 0 0
1/2 HEIGHT CAPACITY: 5936 0 0 0 0
1/4 HEIGHT CAPACITY: 2183 0 0 0 0
TANK DIAMETER: 118.38
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
MAR 6, 2024 10:09 AM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
AUG 10, 2012
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
TST EARLY STOP:DISABLED
+AAMAAQ-
I70300
MAR 6, 2024 10:09 AM
LIQUID TYPE
SENSOR LOCATION TYPE
1 1,2 UDC SUMP TRI-STATE (SINGLE FLOAT)
2 3,4 UDC SUMP TRI-STATE (SINGLE FLOAT)
3 5,6 UDC SUMP TRI-STATE (SINGLE FLOAT)
4 7,8 UDC SUMP TRI-STATE (SINGLE FLOAT)
5 9,10 UDC SUMP TRI-STATE (SINGLE FLOAT)
6 11,12 UDC SUMP TRI-STATE (SINGLE FLOAT)
7 TRI-STATE (SINGLE FLOAT)
8 TRI-STATE (SINGLE FLOAT)
9 UNLEADED STP SUMP TRI-STATE (SINGLE FLOAT)
10 UNLEADED FILL SUMP TRI-STATE (SINGLE FLOAT)
11 PREMIUM STP SUMP TRI-STATE (SINGLE FLOAT)
12 PREMIUM FILL SUMP TRI-STATE (SINGLE FLOAT)
13 DIESEL STP SUMP TRI-STATE (SINGLE FLOAT)
14 DIESEL FILL SUMP TRI-STATE (SINGLE FLOAT)
15 UNLEADED ANNULAR TRI-STATE (SINGLE FLOAT)
16 PREMIUM ANNULAR TRI-STATE (SINGLE FLOAT)
+AAMAAQ-
I10200
MAR 6, 2024 10:09 AM
812765 7-11 36026
3714 W. 11400 S.
SO. JORDAN, UT 84095
M12223071005001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 INTERSTITIAL BD 200950 200586
2 INTERSTITIAL BD 200691 200466
3 4 PROBE / G.T. 162097 161986
4 UNUSED 9324064 9241917
5 UNUSED 9308007 9223552
6 UNUSED 9312456 9222796
7 UNUSED 9307194 9224605
8 UNUSED 9307759 9218857
9 RELAY BOARD 14901 14906
10 UNUSED 9315104 9225810
11 UNUSED 9310249 9214887
12 UNUSED 9313772 9223566
13 UNUSED 9306749 9225787
14 UNUSED 9309368 9220887
15 UNUSED 9306771 9216582
16 UNUSED 9309752 9224848
COMM 1 ELEC DISP INT. 100800 100650
COMM 2 UNUSED 100662 9230894
COMM 3 SERIAL SAT BD 482100 481383
COMM 4 UNUSED 9320095 9228696
COMM 5 RS485 SERIAL BD 68607 68561
COMM 6 MT COMM BOARD 409574 409171
+AAM-