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Underground Storage Tank <br /> Overfill Prevention Equipment Ins ection Report Form <br /> 6. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> Tank ID (One OPE per column) 87_1 87_2 91 <br /> Are both vent and tank riser piping ® Yes ® Yes ® Yes ❑ Yes <br /> secondarily contained? ❑ No ❑ No ❑ No ❑ No <br /> OPE Model Philtite Philtite Philtite <br /> Tank Manufacturer Xerxes 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 <br /> piping that may interfere with the OPE E] Yes E] Yes ❑ Yes <br /> operation? ® No ® No ® No E] No <br /> At what level in the tank is the OPE set to 803/8 803/8 803/8 <br /> activate? (Inches from bottom of tank) <br /> What is the percent capacity of the tank in 95 95 95 <br /> which the OPE activates? <br /> Is the OPE in proper operating condition ® Yes <br /> to respond when the stored substance E Yes ® Yes ❑ Yes <br /> reaches the designated regulatory level? ❑ No ❑ No ❑ No ❑ No <br /> 7. SUMMARY OF TESTING RESULTS <br /> OPE Inspection Results ® Pass ® Pass ® Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Page 2 of 2 <br />