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Underground Storage Tank <br /> Overfill Prevention Equipment Inspection Report <br /> 6. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> Tank ID (one OPE per column) <br /> Are both vent and tank riser piping © Yes © Yes Q Yes 0 Yes <br /> secondarily contained? rl No © No R7 No 0 No <br /> OPE Model <br /> What is the OPE response when 17 Shut off R7 Shut off © Shut off 57 Shut off <br /> activated? Flow Flow Flow Flow <br /> (Check all that apply.) ❑fT Restricts E Restricts © Restricts 0 Restricts <br /> Flow Flow Flow Flow <br /> 9 Audible 0 Audible IM Audible 0 Audible <br /> Alarm Alarm Alarm Alarm <br /> El Visual Visual Visual Visual <br /> Alarm Alarm Alarm Alarm <br /> Are flow restrictors installed on vent piping © Yes* Yes* Yes* Yes* <br /> that may interfere with the OPE operation? ® No ® No ® No r] No <br /> At what level in the tank is the OPE set to <br /> 853/8 853/8 853/8 <br /> activate? Inches from bottom of tank <br /> What is the percent capacity of the tank at 94 .94 .94 <br /> which the OPE activates? <br /> Is the OPE in proper operating condition to Yes 0 Yes* © Yes* 0 Yes* <br /> respond when the stored substance © No © No © No 0 No <br /> reaches the designated regulatory level? <br /> 7. SUMMARY OF TESTING RESULTS <br /> OPE Inspection Results Pass 0 Pass 0 Pass ® Pass <br /> Q Fail © Fail 0 Fail E Fail <br /> 8. COMMENTS <br /> Describe all answers marked "No"or "Fail"and proposed remedy. <br /> List all monitoring equipment either replaced or repaired. <br /> * Mark here if: <br /> ® Flow restrictors interfere with overfill prevention and equipment repairs required. <br /> Additional copies of this page may be attached. <br /> Attach tank chart(s), measurements, calculations, and In-Tank Setup report(s) <br /> Page 2 of 2 <br />