HomeMy WebLinkAbout2021-12-07 BPD- OPI-FAIL Appendix IX Underground Storage Tank Overfill Prevention Equipment Inspection Report Form
CERS = California Environmental Reporting System, ID = Identification, ICC = International Code Council, OPE = Overfill Prevention Equipment Page 1 of 2
TYPE OF ACTION ☐ Installation ☐ Repair ☐ 36 Month
1. FACILITY INFORMATION
CERS ID
Inspection Date
Facility Name
Facility Address
City
ZIP Code
2. SERVICE TECHNICIAN INFORMATION
Company Performing the Inspection
Phone
Mailing Address
Service Technician Performing Inspection
Contractor/Tank Tester License Number
ICC Number
Expiration Date
3. TRAINING AND CERTIFICATIONS
Manufacturer and Test Equipment Training Certifications Expiration Date
4. INSPECTION PROCEDURES INFORMATION
Inspection Procedures Used Components Inspected
5. CERTIFICATION BY SERVICE TECHNICIAN CONDUCTING INSPECTION
I hereby certify that the OPE was inspected in accordance with California Code of
Regulations, title 23, division 3, chapter 16, section 2637.2; that required supporting
documentation is attached; and all information contained herein is accurate. I understand
that test procedures shall be made available upon request by the governing authority.
Service Technician Signature Date
Total # of Pages
Underground Storage Tank Overfill Prevention Equipment Inspection Report
Additional copies of this page may be attached.
Attach tank chart(s), measurements, calculations, and In-Tank Setup report(s) Page 2 of 2
6. OVERFILL PREVENTION EQUIPMENT DETAILS
Tank ID (one OPE per column)
Are both vent and tank riser piping
secondarily contained?
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
OPE Model
What is the OPE response when activated?
(Check all that apply.)
☐ Shut off
Flow
☐Restricts
Flow
☐ Audible
Alarm
☐ Visual
Alarm
☐ Shut off
Flow
☐Restricts
Flow
☐ Audible
Alarm
☐ Visual
Alarm
☐ Shut off
Flow
☐Restricts
Flow
☐ Audible
Alarm
☐ Visual
Alarm
☐ Shut off
Flow
☐Restricts
Flow
☐ Audible
Alarm
☐ Visual
Alarm
Are flow restrictors installed on vent piping
that may interfere with the OPE operation?
☐ Yes*
☐ No
☐ Yes*
☐ No
☐ Yes*
☐ No
☐ Yes*
☐ No
At what level in the tank is the OPE set to
activate? (Inches from bottom of tank)
What is the percent capacity of the tank at
which the OPE activates?
Is the OPE in proper operating condition to
respond when the stored substance
reaches the designated regulatory level?
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
☐ Yes
☐ No
7. SUMMARY OF TESTING RESULTS
OPE Inspection Results ☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
☐ Pass
☐ Fail
1 8. COMMENTS
Describe all results marked “Fail” and each proposed remedy.
* Mark here if:
☐ Flow restrictors interfere with overfill prevention and equipment repairs required.
Check (A) on tank chart
Flapper Depth
(D)
In-Tank Activation Height
H - D = (A)
Product
Tank Diameter
(T)
Riser Height
(R)
Tank 3Tank 2Tank 1
Overfill Prevention Calculations Form
Tank 4
Measurements
Calculation
Total Height
T + R = (H)
* This form and the tank charts must be submitted with test results form
Tank full volume
(V)
Find percent
(A) x 100 ÷ (V)
Modern Welding Company
Subsidiaries Nationwide
www.modweldco.com
modern@modweldco.com
Tank Calibration Chart
Cylindrical Tank / Horizontal Orientation
Striker Plate: 0 inches
Diameter: 119.5 inches
Length: 304.50 inches
Total Volume: 14,784 gallons
Depth
(inches)
Volume
(gallons)
0.000 0
0.500 7
1.000 19
1.500 35
2.000 54
2.500 75
3.000 99
3.500 125
4.000 152
4.500 181
5.000 212
5.500 244
6.000 278
6.500 313
7.000 350
7.500 387
8.000 426
8.500 466
9.000 507
9.500 549
10.000 592
10.500 636
11.000 681
11.500 727
12.000 774
12.500 822
13.000 871
13.500 920
14.000 970
14.500 1,021
15.000 1,073
15.500 1,126
16.000 1,179
16.500 1,233
Depth
(inches)
Volume
(gallons)
17.000 1,288
17.500 1,343
18.000 1,399
18.500 1,456
19.000 1,513
19.500 1,571
20.000 1,629
20.500 1,689
21.000 1,748
21.500 1,808
22.000 1,869
22.500 1,931
23.000 1,992
23.500 2,055
24.000 2,118
24.500 2,181
25.000 2,245
25.500 2,309
26.000 2,374
26.500 2,439
27.000 2,505
27.500 2,571
28.000 2,637
28.500 2,704
29.000 2,772
29.500 2,839
30.000 2,907
30.500 2,976
31.000 3,045
31.500 3,114
32.000 3,184
32.500 3,253
33.000 3,324
33.500 3,394
Depth
(inches)
Volume
(gallons)
34.000 3,465
34.500 3,536
35.000 3,608
35.500 3,680
36.000 3,752
36.500 3,824
37.000 3,897
37.500 3,970
38.000 4,043
38.500 4,117
39.000 4,191
39.500 4,264
40.000 4,339
40.500 4,413
41.000 4,488
41.500 4,563
42.000 4,638
42.500 4,713
43.000 4,789
43.500 4,864
44.000 4,940
44.500 5,016
45.000 5,093
45.500 5,169
46.000 5,245
46.500 5,322
47.000 5,399
47.500 5,476
48.000 5,553
48.500 5,631
49.000 5,708
49.500 5,786
50.000 5,863
50.500 5,941
Depth
(inches)
Volume
(gallons)
51.000 6,019
51.500 6,097
52.000 6,175
52.500 6,253
53.000 6,331
53.500 6,409
54.000 6,488
54.500 6,566
55.000 6,645
55.500 6,723
56.000 6,802
56.500 6,880
57.000 6,959
57.500 7,038
58.000 7,117
58.500 7,195
59.000 7,274
59.500 7,353
60.000 7,432
60.500 7,510
61.000 7,589
61.500 7,668
62.000 7,746
62.500 7,825
63.000 7,904
63.500 7,982
64.000 8,061
64.500 8,140
65.000 8,218
65.500 8,297
66.000 8,375
66.500 8,453
67.000 8,531
67.500 8,610
Depth
(inches)
Volume
(gallons)
68.000 8,688
68.500 8,766
69.000 8,843
69.500 8,921
70.000 8,999
70.500 9,076
71.000 9,154
71.500 9,231
72.000 9,308
72.500 9,385
73.000 9,462
73.500 9,539
74.000 9,615
74.500 9,692
75.000 9,768
75.500 9,844
76.000 9,920
76.500 9,996
77.000 10,071
77.500 10,146
78.000 10,222
78.500 10,296
79.000 10,371
79.500 10,446
80.000 10,520
80.500 10,594
81.000 10,668
81.500 10,741
82.000 10,814
82.500 10,887
83.000 10,960
83.500 11,032
84.000 11,104
84.500 11,176
Depth
(inches)
Volume
(gallons)
85.000 11,248
85.500 11,319
86.000 11,390
86.500 11,461
87.000 11,531
87.500 11,601
88.000 11,670
88.500 11,740
89.000 11,808
89.500 11,877
90.000 11,945
90.500 12,013
91.000 12,080
91.500 12,147
92.000 12,214
92.500 12,280
93.000 12,345
93.500 12,410
94.000 12,475
94.500 12,540
95.000 12,603
95.500 12,667
96.000 12,730
96.500 12,792
97.000 12,854
97.500 12,915
98.000 12,976
98.500 13,036
99.000 13,096
99.500 13,155
100.00013,213
100.50013,271
101.00013,329
101.50013,385
Depth
(inches)
Volume
(gallons)
102.00013,441
102.50013,497
103.00013,551
103.50013,605
104.00013,659
104.50013,711
105.00013,763
105.50013,814
106.00013,864
106.50013,914
107.00013,962
107.50014,010
108.00014,057
108.50014,103
109.00014,148
109.50014,192
110.00014,235
110.50014,277
111.00014,318
111.50014,358
112.00014,397
112.50014,435
113.00014,471
113.50014,506
114.00014,540
114.50014,572
115.00014,603
115.50014,632
116.00014,660
116.50014,685
117.00014,709
117.50014,730
118.00014,749
118.50014,765
Page 1 of 2
This volumetric tank chart is supplied to you for informational purposes only. These capacity calculations are based on
theoretical volumes not actual volumes, and do not reflect atmospheric conditions or thermal expansion/contraction due to
temperature changes. If internal accessories such as pumps are present, displacement of these accessories must be
considered. Therefore, neither Modern Welding Company nor its officers, directors, employee affiliates or subsidiaries shall
be liable for the use of this information covered within. This information is advisory only and the use of the material and
methods is solely at the risk of the user.
Depth
(inches)
Volume
(gallons)
119.00014,778
119.50014,784
Cylindrical Tank / Horizontal Orientation
Striker Plate: 0 inches | Diameter: 119.5 inches | Length: 304.50 inches | Total Volume: 14,784 gallons