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ALTON <br /> NGENEERE'R G, INC. � <br /> Overfill Prevention Inspection- OPW 61 and 71 Series Devices <br /> Date: <br /> Owner: <br /> Facility: <br /> OPW Ov Model Number: <br /> Part 1 - Pr er Height Setting Calculation <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Maximum Tank Volume Per: A Gallons g <br /> /1760? <br /> Max shut off i equirement for flapper is 95% B 95% � <br /> Multiply Max tank volume by 95% C Gallons <br /> r <br /> Use tank chart or ATG to determine height of D Inches <br /> calculated volume <br /> Measure top of fill riser threads,or face seal E Inches <br /> adapter <br /> Tank diameter (From Tank Chart) F Inches <br /> Upper Tube in Tank(G)F-D=G G Inches ` 5 <br /> Subtract 2"frcm upper tube in tank G-2"=K K Inches <br /> Calculated minimum upper tube length(I) I Inches <br /> K+E=I /S/ZS <br /> Actual measur d upper tube length(Without <br /> fill adapter)( J Inches S S <br /> Part 2-Del ice Certification Criteria Evaluation <br /> Does the overfill prevention device meet the 95% <br /> requirement? Ye <br /> Is the actual measured upper tube length 6.5 inches or \ <br /> more than the fill riser?(J must be 6.5"or more than E) 7� 5 <br /> Does the overfill prevention device function as required? <br /> (Inspect the device for damage,contamination,freedom of �g <br /> movement,weakening due to wear and corrosion) <br /> Device Ove Ill Certification PASS /FAEL -�6 <br /> Drop Tube Testing PASS /FAIL Av/A <br /> Technician certifies that the device is operationally compliant. <br /> Signature of echnician: Date: <br /> Technician'sName: <br />