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WALTON <br /> ENGINEERING, INC. <br /> X,of- <br /> Overfill <br /> Prevention Inspection -OPW 61 and 71 Series Devices <br /> Date: �Gf/Gl % D g <br /> Owner: <br /> Facility: <br /> OPW Overfill Model Number: <br /> Part 1 -Proper Height Setting Calculation <br /> Tank 1 Tank 2 Tank 3 Tank 4 <br /> Maximum Tank Volume Per: A Gallons <br /> Max shut off requirement for flapper is 95% s 95% <br /> Multiply Max tank volume by 95% C Gauuns ' <br /> Use tank chart or ATG to determine height of D Inches i <br /> calculated volume <br /> Measure top of fill riser threads,or face seal E Inches <br /> adapter <br /> Tank diameter(From Tank Chart) F Inches I <br /> Upper Tube in Tank(G)F-D=G G Inches <br /> Subtract 2"from upper tube in tank G-2"=K x Inches <br /> Calculated minimum upper tube length(1) I Inches <br /> K+E=I <br /> Actual measured upper tube length(Without J Inches <br /> fill adapter) <br /> Part 2-Device Certification Criteria Evaluation <br /> Does the overfill prevention device meet the 95% <br /> requirement? <br /> Is the actual measured upper tube length 6.5 inches or <br /> more than the fill riser?Q must be 6.5"or more than E) <br /> Does the overfill prevention device function as required? <br /> (Inspect the device for damage,contamination,freedom of <br /> movement,weakening due to wear and corrosion <br /> Device Overfill Certification PASS/FAIL <br /> Drop Tube Testing PASS/FAEL <br /> Technician certifies that the device is operationally compliant. <br /> Signature of Technician: Date: <br /> Technician's Name: <br />