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Underground Storage Tank Overfill Prevention Equipment Inspection Report 6. OVERFILL PREVENTION EQUIPMENT DETAILS Tank ID (one OPE per column) 0001OU001 Are both vent and tank riser piping ❑✓ Yes ❑ Yes ❑ Yes ❑ Yes secondarily contained? ❑ No ❑ No ❑ No ❑ No OPE Model 790091-001 What is the OPE response when activated? ❑ Shut off ❑ Shut off ❑ Shut off ❑ Shut off (Check all that apply.) Flow Flow Flow Flow El Restricts ❑Restricts ❑Restricts ❑Restricts Flow Flow Flow Flow ❑✓ Audible ❑ Audible ❑ Audible ❑ Audible Alarm Alarm Alarm Alarm ❑✓ Visual ❑ Visual ❑ Visual ❑ Visual Alarm Alarm Alarm Alarm Are flow restrictors installed on vent piping ❑ Yes ❑ Yes ❑ Yes ❑ Yes that may interfere with the OPE operation? ❑✓ No ❑ No ❑ No ❑ No At what level in the tank is the OPE set to activate? (Inches from bottom of tank) 53.75 What is the percent capacity of the tank at which the OPE activates? 90 Is the OPE in proper operating condition to ❑✓ Yes ❑ Yes ❑ Yes ❑ Yes respond when the stored substance ❑ No ❑ No ❑ No ❑ No reaches the designated regulatory level? 7. SUMMARY OF TESTING RESULTS OPE Inspection Results ❑✓ Pass ❑ Fail ❑ ❑ Pass Fail ❑ ❑ Pass Fail ❑ ❑ Pass Fail 8. COMMENTS Describe all results marked "Fail" and each proposed remedy. * Mark here if: ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. Additional copies of this page maybe attached. Attach tank chart(s)measurementscalculations, and In -Tank Setup reports) , , Page 2 of 2