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Tanknology <br />Date: <br />Customer Name: <br />Location #: <br />Location Address: <br />OPW Model Number: <br />Overfill Prevention Equipment Inspection <br />OPW 61 and 71 Series Overfill Prevention Device Inspection <br />10/3/2018 <br />CHEVRON PRODUCTS USA <br />99840 <br />4344 E WATERLOO RD @99 ,STOCKTON ,CA , 95215 <br />61-S0 <br />PART 1) Proper height setting calculation <br />Maximum Tank Volume per: Tank Chart A gallons <br />Max shut off requirement for Flapper is 95% B 95% <br />Multiply Maximum tank volume by 95% c gallons <br />Use tank chart or ATG to determine height of calculated volume D inches <br />Measure top of fill riser threads, or face seal adapter E inches <br />Tank diameter From Chart F inches <br />Upper Tube in tank (G) F - D = G G inches <br />Subtract 2 inches from upper tube in tank G - 2"= K K inches <br />Calculated minimum upper tube length (I) K + E = I i inches <br />Actual measured upper tube length (Without fill J inches adapter) (J) <br />Ti T2 <br />14976 19703 <br />0.95 0.95 0.95 0.95 <br />14227.200 18717.850 <br />105.125 105.400 <br />61.500 60.000 <br />117.750 117.750 <br />12.625 12.350 <br />10.625 10.350 <br />72.125 70.350 <br />76.000 79.750 <br />PART 2) Device certification criteria evaluation <br />Criteria 1 <br />Criteria 2 <br />Criteria 3 <br />Does the overfill prevention device meet the 95% requirement? <br />Is the Actual measured upper tube length 6.5 inches <br />or more than the fill riser? (J must be 6.5" or more <br />than E) <br />Does the overfill prevention device function as <br />required? (Inspect the device for damage, <br />contamination, freedom of movement, <br />weakening due to wear and corrosion) <br />Yes Yes <br />Yes Yes <br />Yes Yes <br />Pass Pass <br />PART 3) Device Certification PASS / FAIL <br />Technician certifies that the device is operationally <br />compliant. If the response to Criteria 1, 2 and 3 above <br />are YES <br />Comments: <br />Signature of <br />Technician: <br />$ <br />(..,1 II, v \-) <br />MM. <br />r'L 0 <br />I A <br />Date: 10/3/2018 <br />Edwin Pineda <br /> <br />WO: NW1- 2337821