DERR-2024-006613

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: 4/12/2024
UTAH DEPARTMENT OF ENV. QUALITY
UST
PO Box 144840
SALT LAKE CITY, UT 84114
Test Date: 4/10/2024
Order Number: 2365968
Dear Regulator,
Enclosed are the results of recent testing performed at the following facility:
7-ELEVEN #26794, MKT 1606
109 SOUTH 300 EAST
State ID 4000990
SALT LAKE CITY, UT 84102
Testing performed:
Sincerely,
Dawn Kohlmeyer
Manager, Field Reporting
7-ELEVEN #26794, MKT 1606
109 SOUTH 300 EAST State ID 4000990
SALT LAKE CITY UT 84102
26794
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
04/10/2024
RUL PUL
Vaporless LD-
2000
Vaporless LD-
2000
Vaporless LD-
2000LD2000LD2000LD2000
30
30
75
2
20
3
30
30
75
2
20
3
30
30
75
20
3
UT151
David Mathie
NW1-2365968
Low Sulfur Diesel
TTK4:1 TTNK5:1 TTNK6:1
Impact Valve
Inspection
Impact Valve Operational
Inspection
Work Order:2365968 Date:4/10/2024
Site Name/ID:7-ELEVEN #26794, MKT 1606
Address:109 SOUTH 300 EAST State ID 4000990
City:SALT LAKE CITY State:UT Zip:84102
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 40 Pass Fail Not Tested
3/4 85 Pass Fail Not Tested
3/4 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 #26794, MKT 1606 7-ELEVEN, INC.
109 SOUTH 300 EAST State ID 4000990
SALT LAKE CITY UT 84102
4000990
Tanknology, Inc.
P.O. BOX 711
DALLAS TX 75221
972-828-7575
800-964-1250 04/10/2024
4 5 6
RUL PUL DSL
VR350 VR350 VR350
15071 7002 8039
119.38 119.38 119.38
UT151
David Mathie
109 SOUTH 300 EAST State ID 4000990
7-ELEVEN #26794, MKT 1606
109 SOUTH 300 EAST State ID 4000990, SALT LAKE CITY, UT
8410226794
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
04/10/2024
ANNULAR ANNULAR SB FILL STP SB FILL STP SB FILL
RUL PUL/DSL RUL RUL PUL PUL DSL
UT151
David Mathie
109 SOUTH 300 EAST State ID 4000990
7-ELEVEN #26794, MKT 1606
109 SOUTH 300 EAST State ID 4000990, SALT LAKE CITY, UT
8410226794
Tanknology, Inc.
7-ELEVEN, INC.
P.O. BOX 711
DALLAS, TX 75221
972-828-7575
04/10/2024
STP UDC UDC
DSL 1/2 3/4
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 20 0.0424 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 2.26 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -3.22 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 3.67 Pass
Neg Leak Rate (CFH)0.21 14 0.0297 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.92 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 20 0.0424 Pass
Low High Measured
Pos Cracking (in H2O)2.50 6.00 2.22 Fail
Neg Leak Rate (CFH)0.21 100 0.2120 Fail
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -3.19 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 3.65 Pass
Neg Leak Rate (CFH)0.21 16 0.0339 Pass
Low High Measured
Neg Cracking (in H2O)-10.00 -6.00 -7.87 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: 0.0636

Test Date 4/10/2024
Technician Name David Mathie
WO #2365968
Facility Name / Loc #7-ELEVEN #26794, MKT 1606 26794
Street 109 SOUTH 300 EAST State ID 4000990
City, St, Zip SALT LAKE CITY, UT 84102

Pressure Vacuum Vent Cap Test Form TP-201.1E

7-ELEVEN #26794, MKT 1606
109 SOUTH 300 EAST State ID 4000990
SALT LAKE CITY , UT 84102
26794
Tanknology, Inc.
7-ELEVEN, INC.
972-828-7575
800-800-4633 04/10/2024
RUL
4
15041
118.375
OPW
PUL
5
7258
118.375
OPW
DSL
6
8050
118.375
OPW
UT151
David Mathie
P.O. BOX 711
DALLAS, TX 75221
54.758
15041
101.25
13800
15041
91.7
Site ID/ Name:
Address:
26794 7-ELEVEN #26794, MKT 1606 NW1-2365968 04/10/2024
109 SOUTH 300 EAST State ID 4000990, SALT LAKE
CITY, UT 84102
Tank ID:TK4(RUL)
60
162
7258
100
6647
7258
91.6
Site ID/ Name:
Address:
26794 7-ELEVEN #26794, MKT 1606 NW1-2365968 04/10/2024
109 SOUTH 300 EAST State ID 4000990, SALT LAKE
CITY, UT 84102
Tank ID:TNK5(PUL)
59
162
8050
101
7419
8050
92.2
Site ID/ Name:
Address:
26794 7-ELEVEN #26794, MKT 1606 NW1-2365968 04/10/2024
109 SOUTH 300 EAST State ID 4000990, SALT LAKE
CITY, UT 84102
Tank ID:TNK6(Low Sulfur Diesel)
Tank ID:
Site Diagram
(This site diagram is for reference only and is not drawn to scale)

Work Order:2365968
Site ID / Name:26794 / 7-ELEVEN #26794, MKT 1606
Address:109 SOUTH 300 EAST State ID 4000990
City:SALT LAKE CITY State:UT Zip:84102
W.O.# NW1-2365968
+AAE-
I10100
APR 10, 2024 11:53 AM
166807 7-11 26794
109 S 300 E
SALT LAKE CITY
A0672225305001
SYSTEM STATUS REPORT
ALL FUNCTIONS NORMAL
+AAMAAQ-9999FF1B+AAMAAQ-
I90200
APR 10, 2024 11:53 AM
SOFTWARE REVISION LEVEL
VERSION 333.04
SOFTWARE+ACM- 346333-100-E
CREATED - 13.06.07.08.25
S-MODULE+ACM- 330160-162-A
SYSTEM FEATURES:
PERIODIC IN-TANK TESTS
ANNUAL IN-TANK TESTS
CSLD
BIR
PLLD
0.10 AUTO
0.20 REPETITIV
WPLLD
0.10 AUTO
0.20 REPETITIV
+AAMAAQ-
I20100
APR 10, 2024 11:53 AM
166807 7-11 26794
109 S 300 E
SALT LAKE CITY
A0672225305001
IN-TANK INVENTORY
TANK PRODUCT VOLUME TC VOLUME ULLAGE HEIGHT WATER TEMP
4 REGULAR 5604 5632 9164 47.06 0.00 52.65
5 PREMIUM 1632 1637 5370 33.54 0.00 55.17
6 DIESEL 3103 3110 4936 47.76 0.00 54.25
+AAMAAQ-
I30100
APR 10, 2024 11:53 AM
166807 7-11 26794
109 S 300 E
SALT LAKE CITY
A0672225305001
LIQUID STATUS REPORT
SENSOR LOCATION STATUS
1 RUL ANNULAR SENSOR NORMAL
2 PUL-DSL 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
+AAMAAQ-
I30200
APR 10, 2024 11:53 AM
166807 7-11 26794
109 S 300 E
SALT LAKE CITY
A0672225305001
LIQUID ALARM HISTORY REPORT
SENSOR LOCATION
1 RUL ANNULAR
APR 10, 2024 10:10 AM FUEL ALARM
APR 27, 2023 10:09 AM FUEL ALARM
APR 29, 2022 9:49 AM FUEL ALARM
2 PUL-DSL ANNULAR
APR 10, 2024 10:13 AM FUEL ALARM
APR 27, 2023 9:37 AM FUEL ALARM
APR 29, 2022 10:17 AM FUEL ALARM
3 RUL SPILL BKT
APR 10, 2024 10:27 AM FUEL ALARM
APR 27, 2023 10:02 AM FUEL ALARM
APR 29, 2022 9:46 AM FUEL ALARM
4 RUL STP
APR 10, 2024 9:47 AM FUEL ALARM
APR 27, 2023 9:56 AM FUEL ALARM
APR 29, 2022 9:23 AM FUEL ALARM
5 PUL SPILL BKT
APR 10, 2024 10:34 AM FUEL ALARM
APR 27, 2023 9:49 AM FUEL ALARM
APR 29, 2022 10:03 AM FUEL ALARM
6 PUL STP
APR 10, 2024 11:25 AM FUEL ALARM
APR 10, 2024 9:52 AM FUEL ALARM
APR 27, 2023 9:29 AM FUEL ALARM
7 DSL SPILL BKT
APR 10, 2024 10:41 AM FUEL ALARM
APR 27, 2023 9:52 AM FUEL ALARM
APR 29, 2022 10:11 AM FUEL ALARM
8 DSL STP
APR 10, 2024 10:04 AM FUEL ALARM
APR 27, 2023 9:31 AM FUEL ALARM
APR 29, 2022 10:08 AM FUEL ALARM
9 DISP 1-2
APR 10, 2024 9:38 AM FUEL ALARM
APR 27, 2023 10:23 AM FUEL ALARM
APR 29, 2022 9:10 AM FUEL ALARM
10 DISP 3-4
APR 10, 2024 9:39 AM FUEL ALARM
APR 27, 2023 10:27 AM FUEL ALARM
APR 29, 2022 9:13 AM FUEL ALARM
+AAMAAQ-
IA0100
APR 10, 2024 11:53 AM
TYPE CODE LENGTH SERIAL NO. D/CODE
TANK 4 REGULAR MAG D004 126.00 420315 5004
TANK 5 PREMIUM MAG D004 126.00 420312 5004
TANK 6 DIESEL MAG D004 126.00 420305 5004
+AAMAAQ-
934
TANK 4 SETUP CONDITIONS
PRODUCT: REGULAR
PRODUCT CODE 4
HIGH WATER LIMIT 1.0
OVERFILL LIMIT: 13536
HIGH PRODUCT LIMIT: 14288
LOW PRODUCT: 1330
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 15071 0 0 0 0
3/4 HEIGHT CAPACITY: 12202 0 0 0 0
1/2 HEIGHT CAPACITY: 7572 0 0 0 0
1/4 HEIGHT CAPACITY: 2914 0 0 0 0
TANK DIAMETER: 119.38
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
935
TANK 5 SETUP CONDITIONS
PRODUCT: PREMIUM
PRODUCT CODE 5
HIGH WATER LIMIT 1.0
OVERFILL LIMIT: 6302
HIGH PRODUCT LIMIT: 6651
LOW PRODUCT: 571
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF: 0.000690
DELIVERY DELAY: 5
TANK FULL CAPACITY: 7002 0 0 0 0
3/4 HEIGHT CAPACITY: 5634 0 0 0 0
1/2 HEIGHT CAPACITY: 3508 0 0 0 0
1/4 HEIGHT CAPACITY: 1389 0 0 0 0
TANK DIAMETER: 119.38
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
936
TANK 6 SETUP CONDITIONS
PRODUCT: DIESEL
PRODUCT CODE 6
HIGH WATER LIMIT 1.0
OVERFILL LIMIT: 7235
HIGH PRODUCT LIMIT: 7637
LOW PRODUCT: 648
SUDDEN LOSS LIMIT: 99
LEAK LIMIT: 99
THERMAL COEFF: 0.000450
DELIVERY DELAY: 5
TANK FULL CAPACITY: 8039 0 0 0 0
3/4 HEIGHT CAPACITY: 6858 0 0 0 0
1/2 HEIGHT CAPACITY: 4224 0 0 0 0
1/4 HEIGHT CAPACITY: 1597 0 0 0 0
TANK DIAMETER: 119.38
TANK TILT ADDER: 0.00
MANIFOLDED TANKS: NONE
TANK CONFIGURED: NO
+AAMAAQ-
I61100
APR 10, 2024 11:53 AM
LEAK TEST METHOD
- - - - - - - - - - - -
TEST ON DATE : ALL TANK
JUN 7, 2013
START TIME : DISABLED
TEST RATE :0.20 GAL/HR
DURATION : 2 HOURS
TST EARLY STOP:DISABLED
+AAMAAQ-
I70300
APR 10, 2024 11:53 AM
LIQUID TYPE
SENSOR LOCATION TYPE
1 RUL ANNULAR TRI-STATE (SINGLE FLOAT)
2 PUL-DSL 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 TRI-STATE (SINGLE FLOAT)
12 TRI-STATE (SINGLE FLOAT)
13 TRI-STATE (SINGLE FLOAT)
14 TRI-STATE (SINGLE FLOAT)
15 TRI-STATE (SINGLE FLOAT)
16 TRI-STATE (SINGLE FLOAT)
+AAMAAQ-
I80800
APR 10, 2024 11:53 AM
+AAMAAQ-
I10200
APR 10, 2024 11:53 AM
166807 7-11 26794
109 S 300 E
SALT LAKE CITY
A0672225305001
SYSTEM CONFIGURATION
SLOT BOARD TYPE POWER ON RESET CURRENT
1 4 PROBE / G.T. 157590 162886
2 4 PROBE / G.T. 160634 162623
3 INTERSTITIAL BD 205018 201041
4 INTERSTITIAL BD 210205 201524
5 UNUSED 15000000 9632215
6 UNUSED 8197203 9628786
7 UNUSED 1144556 9634370
8 UNUSED 15000000 9635644
9 UNUSED 15000000 9629878
10 UNUSED 15000000 9622070
11 UNUSED 6829776 9626310
12 UNUSED 15000000 9625777
13 UNUSED 15000000 9621514
14 UNUSED 15000000 9624526
15 UNUSED 15000000 9624341
16 UNUSED 6066591 9625059
COMM 1 ELEC DISP INT. 102228 100673
COMM 2 ELEC DISP INT. 100799 101122
COMM 3 SERIAL SAT BD 453312 484059
COMM 4 UNUSED 15000000 9621839
COMM 5 UNUSED 15000000 9638172
COMM 6 MT COMM BOARD 6473930 408673
+AAM-