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Underground Storage Tank <br /> Overfill Prevention Equipment Inspection Report <br /> S. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> Tank ID (one OPE per column) 3 <br /> Are both vent and tank riser piping es ❑ Yes ❑ Yes ❑ Yes <br /> secondarily contained? ❑ No ❑ No ❑ No ❑ No <br /> OPE Model 0 &.f <br /> What is the OPE response when activated? ❑ Shut off ❑ Shut off ❑ Shut off ❑ Shut off <br /> (Check all that apply.) Zstricts <br /> w Flow Flow Flow <br /> 13 Restricts ❑Restricts 11 Restricts <br /> Flow Flow Flow Flow <br /> ❑ 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 piping ❑ Yes* ❑ Yes* ❑ Yes* ❑ Yes* <br /> that may interfere with the OPE operation? .W No ❑ No ❑ No ❑ No <br /> At what level in the tank is the OPE set to <br /> activate? inches from bottom of tank 2_� <br /> What is the percent capacity of the tank at 9 <br /> which the OPE activates? <br /> Is the OPE in proper operating condition to 9Yes ❑ Yes ❑ Yes ❑ Yes <br /> respond when the stored substance ❑ No ❑ No ❑ No ❑ No <br /> reaches the designated regulatory level? <br /> 7. SUMMARY OF TESTING RESULTS <br /> Pass 13 Pass ❑ Pass El Pass <br /> OPE Inspection Results ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 1.8. COMMENTS <br /> Describe all results marked "Fail"and each proposed remedy. <br /> �CIP119 C�d clre,,v r- <br /> Mark here if: <br /> ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. <br /> Additional copies of this page may be attached. <br /> Attach tank chart(s), measurements, calculations, and In-Tank Setup report(s) <br /> Page 2 of 2 <br />