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INSPECTION WORKSHEET <br /> LIST OVERFILL EQUIPMENT INSPECTION - DEFENDER SERIES"OVERFILL PREVENTION VALVE <br /> Facility Name: owner: <br /> Address: <br /> City,State,Zip Code: Phone: <br /> Testing Company: Phone: Date: <br /> Product Grade: <br /> 1.REFER TO THE MANUFACTURER'S TANK CHART. <br /> Tank Volume(gal) <br /> Tank Diameter(ft) <br /> 95%Tank Volume(gal) <br /> (x Multiply Tank Volume by 0.95) <br /> 95%Volume Height(in inches)Based 1 1 1 1 1 1 <br /> on Calculation Above <br /> 2.PERFORM THE OVERFILL PREVENTION VALVE INSPECTION. <br /> Inspection performed?Flapper moves Yes ❑ Ye, Yes ❑ gee Yes ❑ Yes ❑ <br /> freely into the flow path? No ❑ no No ❑ no No ❑ No ❑ <br /> Measure'A"(in) <br /> Subtract"Z"(in) <br /> Subtract 4.5 in 1 5 1 5 1 5 4.5 1 5 <br /> =Calculated 95% Final Shutoff 2 2 2 2 2 2 <br /> Volume Height(in inches)Based on <br /> Measurements Above <br /> Difference Between 1 and 2(equal or <br /> less than=pass,greather than=fail) <br /> 3.DETERMINE WHETHER THE OVERFILL PREVENTION VALVE INSTALLATION PASSES THE INSPECTION. <br /> Find the Final Shutoff Volume in the <br /> manufacturer's tank chart.Enter the <br /> closest corresponding volume(gal). <br /> Divide by Actual Tank Capacity(gal) <br /> x Multiply by 100 <br /> =Equals Final Shutoff Volume% <br /> If the final shutoff volume percentage is 95%or less,the installation meets FFS and industry recommended practices.This percentage <br /> can,however,exceed 95%as long as the ullage volume remaining is greater than or equal to 250 gallons so that"none of the fittings <br /> located on the top of the tank are exposed to product due to overfilling"according to EPA 40 CFR,Part 280.The installation must also meet <br /> all applicable regulatory requirements,and must be acceptable to the Authority Having Jurisdiction. <br /> Enter Actual Tank Capacity(gal) <br /> -Subtract Final Shutoff Volume(gal) <br /> =Equals UllageVolume Remaining(gal) <br /> The OPV passes the installation Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ Yes ❑ <br /> inspection? No ❑ No ❑ No ❑ No ❑ No ❑ No ❑ <br /> Comments: <br /> Tester's Name(print) Tester's Signature <br /> w19 <br />