Sounds vaugely familiar. Just bought a new cam and tappets from cummins for a friends 01' auto at the tune of $800. Reason for doing so, he called me and said the truck was knocking very badly. When I got to the truck it wasnt knocking,I would say it was a loud tapping sound. I have been through about the same process with this one, still have a noise, just not as bad as when I started. I checked te torque converter and flexplate first. All good there. Pulled the injectors, looked fine wihout any defects, he wanted to try new anyway. Installed jammer stage 5s, noise a little better. Pulled cam and tappets, both measuring below serviceable specs. just installed New cam and tappets, noise still better, but not gone. Running a Fass 150, Drag Comp, 5 in. Grand Rock exhaust, pump was replaced with another stock one a few years ago. 129,000 miles. Diesel shop in the area had same problem on an 01', did everything I have done, tightened the valves down to . 008" to quiet it down enough for the owner to sell it. They couldn't get rid of the noise. Anyone else heard of anything like this?