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Underground Storage Panic <br />OvOr ill PreVOtA011 Equipment Inspection Report <br />:6 .0VERrII-LPREVrN I I0N EQUIPMENT- DETAILS <br />Yank I D (one OPEC per column) <br />m Yes <br />® Yes <br />n Yes <br />Yes <br />Are both vent and tank riser piping <br />secondarily contained? <br />No <br />Tj No <br />® No <br />Na <br />OPE Model <br />vo <br />vv' J d,e <br />What is the OPE response whon <br />Shat off <br />M Smut off <br />Shut off <br />Shut off <br />activated? <br />Flow <br />Flow <br />Flow <br />Flow <br />(Check all that apply.) <br />Restricts <br />(MRestricts <br />n Restricts <br />d Restricts <br />Flow <br />Flow <br />Flow <br />Flaw <br />Audible <br />[n Audible <br />0 Audible <br />[l Audible <br />Alarm <br />Alarm <br />Alarm <br />Alarm <br />Visual <br />® Visual <br />Ej Visual <br />[d Visual <br />Alarm <br />Alarm <br />Alarm <br />Alarm <br />Are flow restrictors installed on vent piping <br />® Yes* <br />Yes* <br />® Yes* <br />® Yes* <br />that may interfere with the OPE operation? <br />R No <br />No <br />r] No <br />No <br />At what level in the tank Is the OPE set to <br />activate? Inches from bottom of tank <br />f=�� ' <br />What Is the percent capacity of the tank at <br />which the OPE activates? <br />Is the OPE in proper operating condition to <br />Yes <br />®Yes* <br />® Yes* <br />respond when the stored substance] <br />No <br />[ No <br />No <br />Q No <br />reaches the designated regulatory level? <br />°7 SUNlM�1�Y ®�; TE�TIN�, R�S.ULTS _ - <br />OPE Inspection Results <br />rj PassFail <br />ass <br />Pass <br />Pass <br />® Fail <br />Fail <br />® Fall <br />Describe all answers marked 'No" or "Fail' and proposed remedy. <br />List alt inonitorirl equipment elther replaced or repaired. <br />S Vo., I eA beCav► -jam ovv is U'?\,J i vN a- Tt N,1 <br />* Mark here if., <br />[n flow restrictors interfere with overfill prevention and equipment repairs required. <br />Additional copies of this page may be attached. <br />Attach tank chart(s), measurements, calculations, and In -Tank Setup report(s) <br />Page 2 of 2 <br />