HomeMy WebLinkAboutOPI 2024 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: 119.75 inches
Length: 303.25 inches
Total Volume: 14,785 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
3.500 124
4.000 152
4.500 181
5.000 211
5.500 244
6.000 277
6.500 312
7.000 348
7.500 386
8.000 425
8.500 464
9.000 505
9.500 547
10.000 590
10.500 634
11.000 679
11.500 725
12.000 772
12.500 819
13.000 868
13.500 917
14.000 967
14.500 1,018
15.000 1,070
15.500 1,122
16.000 1,175
16.500 1,229
Depth
(inches)
Volume
(gallons)
17.000 1,284
17.500 1,339
18.000 1,395
18.500 1,451
19.000 1,509
19.500 1,566
20.000 1,625
20.500 1,684
21.000 1,743
21.500 1,803
22.000 1,864
22.500 1,925
23.000 1,987
23.500 2,049
24.000 2,111
24.500 2,175
25.000 2,238
25.500 2,302
26.000 2,367
26.500 2,432
27.000 2,497
27.500 2,563
28.000 2,630
28.500 2,696
29.000 2,764
29.500 2,831
30.000 2,899
30.500 2,967
31.000 3,036
31.500 3,105
32.000 3,174
32.500 3,244
33.000 3,314
33.500 3,385
Depth
(inches)
Volume
(gallons)
34.000 3,455
34.500 3,526
35.000 3,598
35.500 3,669
36.000 3,741
36.500 3,814
37.000 3,886
37.500 3,959
38.000 4,032
38.500 4,105
39.000 4,179
39.500 4,253
40.000 4,327
40.500 4,401
41.000 4,475
41.500 4,550
42.000 4,625
42.500 4,700
43.000 4,775
43.500 4,851
44.000 4,927
44.500 5,002
45.000 5,079
45.500 5,155
46.000 5,231
46.500 5,308
47.000 5,384
47.500 5,461
48.000 5,538
48.500 5,615
49.000 5,692
49.500 5,770
50.000 5,847
50.500 5,925
Depth
(inches)
Volume
(gallons)
51.000 6,003
51.500 6,080
52.000 6,158
52.500 6,236
53.000 6,314
53.500 6,392
54.000 6,471
54.500 6,549
55.000 6,627
55.500 6,705
56.000 6,784
56.500 6,862
57.000 6,941
57.500 7,019
58.000 7,098
58.500 7,177
59.000 7,255
59.500 7,334
60.000 7,412
60.500 7,491
61.000 7,569
61.500 7,648
62.000 7,727
62.500 7,805
63.000 7,884
63.500 7,962
64.000 8,041
64.500 8,119
65.000 8,197
65.500 8,276
66.000 8,354
66.500 8,432
67.000 8,510
67.500 8,588
Depth
(inches)
Volume
(gallons)
68.000 8,666
68.500 8,744
69.000 8,822
69.500 8,899
70.000 8,977
70.500 9,054
71.000 9,131
71.500 9,209
72.000 9,286
72.500 9,363
73.000 9,439
73.500 9,516
74.000 9,592
74.500 9,669
75.000 9,745
75.500 9,821
76.000 9,897
76.500 9,972
77.000 10,048
77.500 10,123
78.000 10,198
78.500 10,273
79.000 10,347
79.500 10,422
80.000 10,496
80.500 10,570
81.000 10,643
81.500 10,717
82.000 10,790
82.500 10,863
83.000 10,935
83.500 11,008
84.000 11,080
84.500 11,152
Depth
(inches)
Volume
(gallons)
85.000 11,223
85.500 11,294
86.000 11,365
86.500 11,436
87.000 11,506
87.500 11,576
88.000 11,646
88.500 11,715
89.000 11,784
89.500 11,852
90.000 11,920
90.500 11,988
91.000 12,055
91.500 12,122
92.000 12,189
92.500 12,255
93.000 12,321
93.500 12,386
94.000 12,451
94.500 12,515
95.000 12,579
95.500 12,642
96.000 12,705
96.500 12,768
97.000 12,830
97.500 12,891
98.000 12,952
98.500 13,012
99.000 13,072
99.500 13,131
100.00013,190
100.50013,248
101.00013,305
101.50013,362
Depth
(inches)
Volume
(gallons)
102.00013,418
102.50013,474
103.00013,529
103.50013,583
104.00013,636
104.50013,689
105.00013,741
105.50013,793
106.00013,843
106.50013,893
107.00013,942
107.50013,990
108.00014,037
108.50014,083
109.00014,129
109.50014,173
110.00014,217
110.50014,259
111.00014,301
111.50014,341
112.00014,380
112.50014,418
113.00014,455
113.50014,491
114.00014,525
114.50014,558
115.00014,589
115.50014,619
116.00014,648
116.50014,674
117.00014,699
117.50014,721
118.00014,741
118.50014,759
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)
119.00014,773
119.50014,783
Cylindrical Tank / Horizontal Orientation
Striker Plate: 0 inches | Diameter: 119.75 inches | Length: 303.25 inches | Total Volume: 14,785 gallons