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WALTON <br /> vr <br /> Overfill 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 pn <br /> Max shut off requirement for flapper is 95% B 95% <br /> Multiply Max tank volume by 95% C Gallons �Gi <br /> Use tank chart or ATG to determine heitrht of <br /> calculated volume n Inches G 7 <br /> Measure top of fill riser threads,or face seal L' <br /> > Inches <br /> ada ter <br /> Tank diameter(From Tank Chart) F Inches /� 3 <br /> Upper Tube in Tank(G)F-D=G G Inches <br /> Subtract 2"from upper tube in tank G-2"=K K inches C• �/ <br /> Calculated minimum upper tube length(I) <br /> K+E=I Ilnches <br /> Actual measured upper tube length(Without <br /> fill ada ter)(J) Inches <br /> Part 2 - Device Certification Criteria Evaluation <br /> Does the overfill prevention device meet the 95 k <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 compliant. w� <br /> v,4y <br /> V <br /> Signature of Technician: Date- <br /> Technician's Name: `�� rQ <br /> �J O <br />