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WALTON <br /> Overriill Prevention Inspection - OPW 61 and 71 Series Devices <br /> Date: <br /> Owner: <br /> Facility: <br /> OPW Overfill Model Number: <br /> Part 1 - Proper Height Setting Calculation <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Maximum Tank Volume Per: A Gallons CI 612 <br /> Max shut off requirement for flapper is 95% s 95% ��'• � <br /> Multiply Max tank volume by 95% c Gallons <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 Tani:(G)F-D=G G Inches J� <br /> Subtract 2"from upper tube in tank G-2"=K K Inches <br /> Calculated minimum upper tube length([) <br /> K+E=l I Inches <br /> Actual measured upper tube length(Without <br /> fill adapter)(J) J inches <br /> Part 2- Device Certification Criteria Evaluation <br /> Does the overfill prevention device meet the 95% <br /> requirement? <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) <br /> Does the overfill prevention device function as required? <br /> (Inspect the device for damage,contamination,freedom of <br /> movement,weakening due to wear and corrosion) <br /> Device Overfill Certification PASS /FAIL <br /> Drop Tube Testing PASS /FAIL <br /> Technician certifies that the device is operationally complian U*'® <br /> Signature of Technician: Date: <br /> Technician's Name: W,ON�� ( S'�� <br />