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Underground Storage Tank Permit #SR0083767 Overfill Prevention Equipment Inspection Report 6. OVERFILL PREVENTION EQUIPMENT DETAILS Tank ID (one OPE per column) ❑ Yes ❑ Yes ❑ Yes ❑ Yes Are both vent and tank riser piping secondarily contained? ❑X No ❑ No ❑ No ❑ No OPE Model What is the OPE response when Z Shut off ❑ Shut off ❑ Shut off ❑ Shut off activated? Flow Flow Flow Flow (Check all that apply.) ❑ Restricts ❑Restricts ❑ Restricts ❑ Restricts Flow Flow Flow Flow ❑ Audible ❑ Audible ❑ Audible ❑ Audible Alarm Alarm Alarm Alarm ❑ Visual ❑ Visual ❑ Visual ❑ Visual Alarm Alarm Alarm Alarm Are flow restrictors installed on vent piping ❑ Yes* ❑ Yes* ❑ Yes* ❑ Yes* that may interfere with the OPE operation? 0 No ❑ No ❑ No ❑ No At what level in the tank is the OPE set to 907 activate? Inches from bottom of tank What is the percent capacity of the tank at 94 which the OPE activates? Is the OPE in proper operating condition to 0 Yes ❑ Yes* ❑ Yes* ❑ Yes* respond when the stored substance ❑ No ❑ No ❑ No ❑ No reaches the designated regulatory level? 7. SUMMARY OF TESTING RESULTS ❑ Pass ❑ Pass ❑ Pass ❑ Pass OPE Inspection Results ❑ Fail tO Fail ❑ Fail ❑ Fail 8. COMMENTS Describe all answers marked "No" or "Fail' and proposed remedy. List all monitoring equipment either replaced or repaired. * Mark here if: ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. Additional copies of this page may be attached. Attach tank chart(s), measurements, calculations, and In -Tank Setup report(s) Page 2 of 2