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.i Tanknology <br />Date: <br />Customer Name: <br />Location #: <br />Location Address: <br />DPW Model Number: <br />Overfill Prevention Equipment Inspection <br />OPW 61 and 71 Series Overfill Prevention Device Inspection <br />11/8/2021 <br />UNFI <br />Stockton <br />1990 Piccoli Road ,Stockton ,CA , 95215 <br />PART 1) Proper height setting calculation <br />Maximum Tank Volume per: Agallons <br />Max shut off requirement for Flapper is 95% B95i <br />Multiply Maximum tank volume by 95% C gallons <br />Use tank chart to determine height of calculated volume D inches <br />Measure top of fill riser threads, or face seal adapter when used, to tank top E inches <br />Tank diameter From Chart F inches <br />Upper Tube in tank (G) F - D = G <br />Subtract 2 inches from upper tube in tank G - 2"= H <br />G inches <br />H inches <br />Calculated minimum upper tube length (1) H + E = I Iinches <br />Actual measured upper tube length (Without fill <br />finches <br />adapter) (J) <br />PART 2) Device certification criteria evaluation <br />Criteria 1 <br />Does the overfill prevention device meet the 95% requirement? <br />Dsl <br />20237.000 <br />0.95 <br />0.95 <br />0.95 <br />0.95 <br />19225.150 <br />107.125 <br />45.000 <br />113.000 <br />5.875 <br />3.875 <br />48.875 <br />57.250 <br />Yes <br />Criteria 1 a If the final shutoff volume is installed greater than 95%, is there at <br />least 250 gallons of ullage above the overfill device activation point Yes <br />to ensure that none of the tank top fittings are exposed to product, <br />meeting the criteria established in EPA 280.20iic and per OPW <br />installation guidelines. <br />Criteria 2 Is the Actual measured upper tube length 6.5 inches Yes <br />or more than the fill riser? (J must be 6.5" or more <br />than E) <br />Criteria 3 Does the overfill prevention device function as <br />required? (Inspect the device for damage, Yes <br />contamination, freedom of movement, <br />weakening due to wear and corrosion) <br />PART 3) Device Certification PASS / FAIL <br />Pass <br />Technician certifies that the device is operationally <br />compliant. <br />;omments: <br />Signature of Technician: Date: 11/8/2021 <br />Brent Bowen <br />WO: NW1- 2353287 <br />