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Underground Storage Tank Overfill Prevention Equipment Inspection Report 6. OVERFILL PREVENTION EQUIPMENT DETAILS Tank ID (one OPE per column) T-1 regular T-2 Plus T-3 Premium T-4 Diesel Are both vent and tank riser piping ❑✓ Yes [Z]Yes ❑✓ Yes ❑✓ Yes secondarily contained? ❑ No ❑ No ❑ No ❑ No OPE Model Emco A1100EVR Emco A1100EVR Emco A1100EVR Emco A1100EVR What is the OPE response when activated? Shut off Shut off F,/] Shut off ❑✓ Shut off (Check all that apply.) Flow Flow Flow Flow ❑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? ❑✓ No ❑✓ No ❑✓ No ❑✓ No At what level in the tank is the OPE set to 85 1/2" 85 3/4" 85" 85 1/4" activate? (Inches from bottom of tank) What is the percent capacity of the tank at 94% 94% 94% 94%which the OPE activates? Is the OPE in proper operating condition to ❑✓ 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 ❑ Fail ❑ Fail ❑ Fail 8. COMMENTS Describe all results marked "Fail" and each proposed remedy. * 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