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Underground Storage Tank <br />nvPrfill PrPvPntion Fouioment Inspection Report Form <br />6. OVERFILL PREVENTION EQUIPMENT DETAILS <br />Tank ID (One OPE per column) <br />87 <br />91 <br />DSL <br />Are both vent and tank riser piping <br />® Yes <br />® Yes <br />® Yes <br />❑ Yes <br />secondarily contained? <br />❑ No <br />❑ No <br />❑ No <br />❑ No <br />OPE Model <br />EBW <br />EBW <br />EBW <br />Tank Manufacturer <br />Mod Weld <br />Mod Weld <br />Mod Weld <br />® Shuts off <br />® Shuts off <br />® Shuts off <br />❑ Shuts off <br />Flow <br />Flow <br />Flow <br />Flow <br />❑ Restricts <br />❑ Restricts <br />❑ Restricts <br />❑ Restricts <br />What is the OPE response when <br />Flow <br />Flow <br />Flow <br />Flow <br />activated? <br />❑ Audible <br />❑ Audible <br />❑ Audible <br />❑ Audible <br />(Check a# that apply.) <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 <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />❑ Yes <br />piping that may interfere with the OPE <br />® No <br />® No <br />® No <br />❑ No <br />operation? <br />At what level in the tank is the OPE set to <br />106" <br />106" <br />106" <br />activate? (Inches from bottom of tank) <br />What is the percent capacity of the tank in <br />94% <br />94% <br />94% <br />which the OPE activates? <br />Is the OPE in proper operating condition <br />® Yes <br />® Yes <br />® Yes <br />❑ Yes <br />to respond when the stored substance <br />❑ No <br />❑ No <br />❑ No <br />❑ No <br />reaches the designated regulatory level? <br />MARY OF TESTING RESULTS <br />EOPE <br />® Pass ® Pass <br />® Pass <br />❑ Pass <br />spection Results <br />❑ Fail ❑ Fail <br />❑ Fail <br />❑ Fail <br />8. COMMENTS <br />Replaced straight drop tubes with flapper drop tubes, per regulation, with inspector on site. <br />Test passed. <br />