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k <br />Underground Storage Tank <br />Overfill Prevention Equipment Inspection Report <br />Tank ID (one OPE percofurr►n) 1-1/Diesel T-1/Diesel <br />Are both vent and tank riser piping m Yes m Yes ❑ Yes ❑ Yes <br />secondarily contained? ❑ No ❑ No ❑ No ❑ No <br />OPE Model EBW MP4505 <br />What is the OPE response when activated? m Shut off ❑ Shut off ❑ Shut off ❑ Shut off <br />(Check all that apply.) Flow Flow Flow Flow <br />❑ Restricts ❑ Restricts ❑ Restricts ❑ Restricts <br />Flow Flow Flow Flow <br />❑ Audible m Audible ❑ Audible ❑ Audible <br />Alarm Alarm Alarm Alarm <br />❑ Visual m 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? m No m No ❑ No ❑ No <br />At what level in the tank is the OPE set to 41.50 39.75 <br />activate? Inches from bottom of tank <br />What is the percent capacity of the tank at 93 90 <br />which the OPE activates? <br />Is the OPE in proper operating condition to m Yes m Yes ❑ Yes ❑ Yes <br />respond when the stored substance ❑ No ❑ No ❑ No ❑ No <br />reaches the designated regulatory level? <br />OPE Inspection Results 10 Fail 10 Fail I ❑ Fail I ❑ Fail <br />Describe all results marked "Fail" and each proposed remedy. <br />* Mark here if: <br />❑ Flow restrictors interfere with overfill prevention and equipment repairs required. <br />Additional copies of this page maybe attached. <br />Attach tank chart(s), measurements, calculations, and In -Tank Setup reports) <br />Page 2 of 2 <br />