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Underground Storage Tank Overfill Prevention Equipment Inspection Report 6. OVERFILL PREVENTION EQUIPMENT DETAILS Tank ID (one OPE per column) T1 87A T2 87B T3 87C T4 91 Are both vent and tank riser piping ® Yes ® Yes ® Yes ® Yes secondarily contained? ❑ No ❑ No ❑ No ❑ No OPE Model EBW EBW EBW EBW What is the OPE response when ® Shut off ® Shut off M Shut off ® Shut off activated? Flow Flow Flow Flow (Check all that apply.) ❑ Restricts ❑ Restricts ❑ Restricts ❑ Restricts Flow Flow Flow Flow ❑ Audible ❑ Audible ❑ Audible ❑ Audible Alarm Alarm Alarm Alarm ❑ Visual ❑ Visual ❑ Visual ❑ Visual Alarm Alarm Alarm Alarm Are flow restrictors installed on vent ❑ Yes* ❑ Yes* ❑ Yes* ❑ Yes* piping that may interfere with the OPE ® No ® No ® No ® No operation? At what level in the tank is the OPE 103.5 inch 103.5 inch 103.5 inch 106.25 inch set to activate? Inches from bottom of What is the percent capacity of the 93.5% 93.5% 93.5% 94% tank at which the OPE activates? Is the OPE in proper operating ® Yes ® Yes ® Yes ® Yes condition to respond when the stored ❑ No ❑ No ❑ No ❑ No substance reaches the designated regulatory level? 7. SUMMARY OF TESTING RESULTS ® Pass ® Pass ® Pass ® Pass- ass❑ OPE Inspection Results 0Fail ❑ Fail ❑ Fail ❑ Fail 8. COMMENTS Describe all results marked "Fail" and each proposed remedy. * Mark here if: ❑ Flow restrictors interfere with overfill prevention and equipment repairs required. Additional copies of this page may be attached. Attach tank chart(s), measurements, calculations, and In -Tank Setup report(s) Page 2 of 2