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Underground Storage Tank Overfill Prevention Equipment Inspection Report 6. OVERFILL PREVENTION EQUIPMENT DETAILS Tank ID (one OPE per column) 87 ® Yes 87 ® Yes 91 ® Yes DIESEL Yes Are both vent and tank riser piping secondarily contained? ® No © No No © No OPE Model OPw OPw OPw OPw What is the OPE response when M Shut off ® Shut off M Shut off [ Shut off activated? Flow Flow Flow Flow (Check all that apply.) ® Restricts EIRestricts M Restricts ® Restricts Flow Flow Flow Flow © Audible 0 Audible © Audible 0 Audible Alarm Alarm Alarm Alarm Q Visual [71 Visual Visual Visual Alarm Alarm Alarm Alarm Are flow restrictors installed on vent piping ® Yes* i Yes* © Yes* ® Yes* that may interfere with the OPE operation? No No No No At what level in the tank is the OPE set to activate? Inches from bottom of tank) 80.250" 79.5" 80.250" 81" What is the percent capacity of the tank at which the OPE activates? 94.125% 93.750% 94.125% 94.750% Is the OPE in proper operating condition to Yes 0 Yes* Q Yes* ® Yes* respond when the stored substance ❑I— No 0 No No 0 No reaches the designated regulatory level? 7. SUMMARY OF TESTING RESULTS OPE Inspection Results Pass ❑fT Pass Q Pass ©✓ Pass Fail Fail Fail © Fail 8. COMMENTS Describe all answers marked "No" or "Fail" and proposed remedy. List all monitoring equipment either replaced or repaired. NO FLOW RESTRICTORS * 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