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Underground Storage Tank <br />Overfill Prevention Equipment Testing Report Form <br />fi. OVERFILL PREVENTION EQUIPMENT DETAILS <br />Test Method Developed by e Manufacturer ❑ Industry Standard 0 Professional Engineer <br />0 heck this box if Appendix 7.1 continuation page is attached. <br />Tank ID (one OPE per column) <br />87 <br />91 <br />DSL <br />Tank Manufacturer <br />Owers Corning <br />Owens Corning <br />Owens Corning <br />Tank Capacity (Gallons) <br />10000 <br />10000 <br />10000 <br />Tank Inside Diameter (Inches) <br />9214 <br />92" <br />" <br />Are both vent and tank riser piping <br />1111 Yea <br />a Yes <br />d Yes <br />❑ Yes <br />secondarily contained? <br />CI No <br />El No <br />❑ No <br />OPW 71SO <br />0 No <br />OPE Manufacturer I Model <br />OPW 71SO <br />OPW 71 SO <br />What is the OPE response when activated? <br />N Shut off <br />S Shut off <br />19 Shut off <br />❑ Shut off <br />{Check all that apply <br />® Restrict <br />K Restrict <br />Q Restrict <br />Q Restrict <br />❑ Audible <br />Q Audible <br />❑ Audible <br />❑ Audible <br />❑ Visual <br />❑ Visual <br />Q Visual <br />❑ Visual <br />Are flaw restrictors installed on vent piping <br />❑ Yes* <br />R Yes* <br />17 Yes* <br />❑ Yes* <br />that may interfere with the OPE operation?_ <br />e No <br />N No <br />a No <br />❑ No <br />For audible/visual overfill alarms, are they <br />d Yes <br />a Yes <br />® Yes <br />❑ Yes <br />clearly audiblelvisible at the tank fill point's <br />❑ No <br />0 No <br />❑ No <br />C r; _ <br />At what level in the tank does the OPE <br />activate? (!redoes from bottom of tank) <br />77.125" <br />76.375" <br />75.25" <br />What is the percent capacity of the tank at <br />90° <br />89% <br />89% <br />which the OPE activates? <br />Is the OPE in proper operating condition to <br />p Yes <br />S Yes <br />N Yes <br />❑ Yes <br />respond when the stored substance reaches <br />the designated regulatory level? <br />Cl No <br />❑ No <br />❑ No <br />❑ No <br />7. SUMMARY OF TEST RESULTS <br />OPE Test Results <br />a Pass <br />a Pass <br />® Pass <br />❑ Pass <br />Q Fail <br />d Fail <br />0 Fail <br />0 Fail <br />8. COMMENTS <br />D Check this box j flow restrictors in.terfere with overfill prevention and re pajrs are req aired, <br />All tests marked "Fail" and any repairs made during the test must be described in Section 8. <br />Attach tank chart(s), measurements, calculations, and In -Tank Setup reporf(s) Page 2 of 2 <br />