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Overfill Prevention Devioe Inspection: <br /> Tank# Tank# Tank# Tank# Tank# <br /> 1 Diesel 2 Diesel 3 Elodiesel <br /> All tank top fittings are visually in good condition and vapor tight (: Yes (' No Ct Yes (� No Yes ( No (� Yes No <br /> If No, provide additional information: <br /> Ball Roat Valve Present(If No Ball Float, leave next three questions blank) f Yes G No f Yes r No (' Yes f« No f Yes f No <br /> Ball float valve is in good visual condition. r Yes f No fYes (' No fYes f No Yes f No <br /> (Fbmove fitting/cap to visually confirm) <br /> Standard drop tube is properly installed in the tank fill riser. (Y/N) ( Yes (• No r Yes (*' No C" Yes (: No r Yes (No <br /> Indicate tank capacity when flow restriction occurs. <br /> (%) (%) (%) <br /> (Gbtermined by completing TanknologyCHerfill Prevention Epuiorrtent 95 95 95 (%) <br /> Inspection form,available in Technicians Frotocols�scan and upload into order) <br /> If No to any of the Ball Float Valve Questions, provide additional information: <br /> Rapper Valve present(Drop Tube Device) (If No Flapper Valve, leave next four questions blank) r Yes (No G Yes (' No Yes (No (' Yes (No <br /> Flapper valve is not obstructed, <br /> ( <br /> (Fbmove tank fill cap and visually confirm) Yes (' No Yes (" No Yes (` No (" Yes (` No <br /> Tight fill adaptor is installed correctly and in good condition. (. Yes (No r Yes (_ No (+' Yes (No (_ Yes (No <br /> Drop tube assembly is in good condition and all gaskets/seals are in place. r* Yes (No IT* Yes r No (+' Yes (No (Yes (_ No <br /> Indicate tank capacity when complete shut-off occurs <br /> (Determined by completing TANCS L)i rfill 1n8�Q VV Rapper Valve form) 9s i%I 9s c%I 9s 1%I M <br /> If No to any of the Flapper Valve Questions, provide additional information: <br /> Inspection Results <br /> (i Pass r Fail (* Pass r Fail G Pass r Fail r Pass r Fail <br /> If No was selected for any of the items above,select Fail <br /> "This form may be utilized to document inspection of overfill prevention device in the absence of a manufacturer recommended test form and protocol,or a Sate <br /> approved third party test form and procedure. <br /> WO# 2335977 <br />