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U derground Storage Tank <br /> Overfill Prevention Equipment InS ection Report Form <br /> 6. OVERFILL PREVENTION EQUIP ENT DETAILS <br /> Tank ID (One OPE per column) DSL 1 DSL 2 <br /> Large <br /> Are both vent and tank riser piping ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> secondarily contained? ® No ® No ❑ No ❑ No <br /> OPE Model OPW OPW <br /> Tank Manufacturer Xerxes Xerxes <br /> ® Shuts off ® Shuts off ❑ Shuts off ❑ Shuts off <br /> Flow Flow Flow Flow <br /> What is the OPE response when ❑ Restricts ❑ Restricts ❑ Restricts ❑ Restricts <br /> activated? Flow Flow Flow Flow <br /> (Check a#that apply.) ❑ Audible ❑ Audible ❑ Audible ❑ Audible <br /> Alarm Alarm Alarm Alarm <br /> ❑Visual ❑Visual ❑Visual ❑Visual <br /> Alarm Alarm Alarm Alarm <br /> Are flow restrictors installed on vent ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> piping that may interfere with the OPE ® No ® No ❑ No ❑ No <br /> operation? <br /> At what level in the tank is the OPE set to 81" 77„ <br /> activate? (Inches from bottom of tank) <br /> What is the percent capacity of the tank in over 95% 85% <br /> which the OPE activates? <br /> Is the OPE in proper operating condition ® Yes ® Yes ❑ Yes ❑ Yes <br /> to respond when the stored substance ❑ No ❑ No ❑ No ❑ No <br /> reaches the designated regulatory level? <br /> 7. SUMMARY OF TESTING RESULTS <br /> OPE Inspection Results ❑ Pass ® Pass ❑ Pass ❑ Pass <br /> ® Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> DSL 1 Large drop tube is over 95% per regulation. Will need to return, replace and retest. <br /> Page 2 of 2 <br />