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Underground Storage Tank <br /> Overfill Prevention Equipment Ins ection Report Form <br /> 6. OVERFILL PREVENTION EQUIPMENT DETAILS <br /> Tank ID (One OPE per column) 87 91 DSL <br /> Are both vent and tank riser piping ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> secondarily contained? E No E No E No ❑ No <br /> OPE Model OPW OPW OPW <br /> Tank Manufacturer Mod Weld Mod Weld Mod Weld <br /> E Shuts off E Shuts off E Shuts off ❑ Shuts off <br /> Flow Flow Flow Flow <br /> What is the OPE response when ❑ Restricts ❑ Restricts ❑ Restricts ❑ Restricts <br /> activated? Flow Flow Flow Flow <br /> (Check a#that apply.) ❑ 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 ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> piping that may interfere with the OPE E No E No E No ❑ No <br /> operation? <br /> At what level in the tank is the OPE set to 100" 100" 100" <br /> activate? (Inches from bottom of tank) <br /> What is the percent capacity of the tank in 95% 95% 95% <br /> which the OPE activates? <br /> Is the OPE in proper operating condition E Yes E Yes E Yes ❑ Yes <br /> to respond when the stored substance ❑ No ❑ No ❑ No ❑ No <br /> reaches the designated regulatory level? <br /> 7. SUMMARY OF TESTING RESULTS <br /> OPE Inspection Results E Pass E Pass E Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Page 2 of 2 <br />