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L <br /> OPV INSTALLATION RECORD SHEET <br /> Date Installed Valve Serial Number <br /> 5 0 O <br /> Site information <br /> Site#/Description <br /> Site Address <br /> Site Contact <br /> Installing Contractor <br /> Name <br /> Company <br /> Tank Information <br /> Product Type <br /> Underground Tank Manufacturer <br /> Tank Full Volume <br /> Tank Diameter <br /> Tank Chart Available? ❑ Yes ❑ No <br /> Tank Type ❑ Steel ❑ Fiberglass <br /> ❑ Square ❑ Cylinder ❑ Dome Ends <br /> Tank have compartments? ❑ Yes ❑ No <br /> Tank/Drop Tube Measurements <br /> Upper Drop Tube Length (X) Dimensions <br /> Lower Drop Tube Length (Y) A <br /> Distance from Lower Drop tube to tank bottom B <br /> Operational Inspection Procedure Performed Final Shutoff Setpoint <br /> Gallons <br /> ❑ Yes Initials Date o <br /> /o Tank Fill <br /> ❑ No <br /> _.a <br /> 21 <br />