year/make/model type of engine and truck? -- Is it deleted?-- or stock w all emissions? -- When is the last time the engine was gone through and intake and exhaust sensors replaced, manifolds cleaned, etc.etc.etc.
some detailed history, mileage, and what service work has been done so far?
Since you mentioned 'actuators'... I can only assume you mean an ISX that is not common rail?.. if that is the case, did anyone bother to first do an overhead valve adjustment + set all injectors to 8 N_m (71 in/lbs), followed by an injector leak test? ...