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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 />87 <br />DSL <br />Are both vent and tank riser piping <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />secondarily contained? <br />p No <br />0 No <br />❑ No <br />❑ No <br />OPE Model <br />oPw <br />oPw <br />What is the OPE response when activated? <br />p Shut off <br />p Shut off <br />❑ Shut off <br />❑ Shut off <br />(Check all that apply.) <br />Flow <br />Flow <br />Flow <br />Flow <br />❑Restricts <br />❑Restricts <br />❑Restricts <br />❑Restricts <br />Flow <br />Flow <br />Flow <br />Flow <br />❑ Audible <br />❑ Audible <br />❑ Audible <br />❑ Audible <br />Alarm <br />Alarm <br />Alarm <br />Alarm <br />❑ Visual <br />❑ Visual <br />❑ Visual <br />❑ Visual <br />Alarm <br />Alarm <br />Alarm <br />Alarm <br />Are flow restrictors installed on vent piping <br />❑ Yes* <br />❑ Yes* <br />❑ Yes* <br />❑ Yes* <br />that may interfere with the OPE operation? <br />p No <br />p No <br />❑ No <br />❑ No <br />At what level in the tank is the OPE set to <br />86 <br />84 <br />activate? (Inches from bottom of tank) <br />What is the percent capacity of the tank at <br />95.1 <br />93.5 <br />which the OPE activates? <br />Is the OPE in proper operating condition to <br />❑ Yes <br />0 Yes <br />❑ Yes <br />❑ Yes <br />respond when the stored substance <br />p No <br />❑ No <br />❑ No <br />❑ No <br />reaches the designated regulatory level? <br />7. SUMMARY OF TESTING RESULTS <br />❑ Pass <br />0 Pass <br />❑ Pass <br />❑ Pass <br />OPE Inspection Results <br />El Fail <br />❑ Fail <br />❑ Fail <br />❑ Fail <br />8. COMMENTS <br />Describe all results marked "Fail' and each proposed remedy. <br />87 DROP TUBE NEEDS REPLACED <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 />