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Underground Storage Tank <br /> Overfill Prevention Equipment Inspection Report <br /> 6. OVER <br /> -ILL PREVENTION EQUIPMENT DETAILS <br /> Tank I® (one OPS'per column) <br /> Are both vent and tank riser piping ❑ Yes ❑ Yes ❑ Yes ❑ Yes <br /> secondarily contained? ®' No ❑ No ❑ No ❑ No <br /> OPE Model <br /> What is the OPE response when activated? 19 Shut off ❑ Shut off ❑ Shut off ❑ Shut off <br /> (Check all that apply.) Flow Flow Flow Flow <br /> [Restricts ❑Restricts ❑Restricts El Restricts <br /> Flow Flow Flow Flow <br /> ❑ 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 piping ❑ Yes* ❑ Yes* ❑ Yes* ❑ Yes* <br /> that may interfere with the OPE operation? �a No ❑ No ❑ No ❑ No <br /> At what level in the tank is the OPE set to al <br /> activate? Inches from bottom of tank <br /> What is the percent capacity of the tank at <br /> which the OPE activates? <br /> Is the OPE in proper operating condition to K Yes ❑ Yes ❑ Yes ❑ Yes <br /> 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 0 Pass ❑ Pass ❑ Pass ❑ Pass <br /> ❑ Fail ❑ Fail ❑ Fail ❑ Fail <br /> 8. COMMENTS <br /> Describe all results marked "Fail"and each proposed remedy. <br /> ;I <br /> i <br /> * Mark here if. <br /> ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. <br /> Additional copies of this page may be attached. I <br /> Attach tank chart(s), measurements, calculations, and In-Tank Setup reports) <br /> Page 2of2 <br />