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aw Tanknology <br />Date: <br />Customer Name: <br />Location #: <br />Location Address: <br />OPW Model Number: <br />Overfill Prevention Equipment Inspection <br />OPW 61 and 71 Series Overfill Prevention Device Inspection <br />4/19/2019 <br />7 -ELEVEN, INC. -PROJECT FORUM <br />38153 <br />121 S. Center Street ,Stockton ,CA , 95202 <br />OPW 71S0 <br />PART 1) Proper height setting calculation <br />Maximum Tank Volume per: Tank Chart agallons <br />Max shut off requirement for Flapper is 95% es5% <br />Multiply Maximum tank volume by 95% c gaiions <br />Use tank chart or ATG to determine height of calculated volume o inches <br />Measure top of fill riser threads, or face seal adapter a inches <br />Tank diameter From Chart Finches <br />Upper Tube in tank (G) F - D = G cinches <br />Subtract 2 inches from upper tube in tank G - 219 <br />= K K inches <br />Calculated minimum upper tube length (I) K + E = I i inches <br />Actual measured upper tube length (Without fill <br />J inches <br />adapter) (J) <br />PART 2) Device certification criteria evaluation <br />Criteria 1 <br />Does the overfill prevention device meet the 95% requirement? <br />Criteria 1 a If the final shutoff volume is installed greater than 95%, is there at <br />least 250 gallons of ullage above the overfill device activation point <br />to ensure that none of the tank top fittings are exposed to product, <br />meeting the criteria established in EPA 280.20iic and per OPW <br />installation guidelines. <br />Criteria 2 Is the Actual measured upper tube length 6.5 inches <br />or more than the fill riser? (J must be 6.5" or more <br />than E) <br />Criteria 3 Does the overf <br />ill prevention device function as <br />required? (Inspect the device for damage, <br />contamination, freedom of movement, <br />weakening due to wear and corrosion) <br />PART 3) Device Certification PASS /FAIL <br />Technician certifies that the device is operationally <br />compliant. <br />ents: <br />Signature of Technician: <br />WO: NW1- 2341372 <br />Jesus Saldivar <br />T1: REGULAR T2: PREMIUM T3:DIESEL <br />UNLEADED UNLEADED <br />19782 7901 11904 <br />0.95 <br />0.95 <br />0.95 <br />0.95 <br />18792.900 <br />7505.950 <br />11308.800 <br />106.250 <br />106.875 <br />105.750 <br />47.750 <br />42.750 <br />42.250 <br />118.375 <br />118,375 <br />118.375 <br />12.125 <br />11.500 <br />12.625 <br />10.125 <br />9.500 <br />10.625 <br />57.875 <br />52.250 <br />52.875 <br />58.750 <br />53.000 <br />54.000 <br />Yes Yes Yes <br />Yes Yes Yes <br />Yes Yes Yes <br />Yes Yes Yes <br />Pass Pass Pass <br />Date: <br />4/19/2019 <br />