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After failing the emissions test only in the low speed hydrocarbon portion, I decided to do a compression test along with the spark plug change. It was run dry and cold (some of the plugs on the E150 are extremely difficult to remove and not very practical to try on a warm engine).
I got the following readings:
Front
202 200
190 202
200 175
180 202
The plugs were all a light gray, with no deposits or damage, and appear basically identical.
That's basically good, right? That 175 cylinder's a bit low but that's not alarmingly low is it?