DERR-2024-011938

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Recommended Practices for the Testing and Verification of Spill, Overfill, Leak Detection and Secondary Containment Equipment at UST Facilities
APPENDIX C-5
Tester’s Name (print) ___________________________________ Tester’s Signature __________________________________
UST OVERFILL EQUIPMENT INSPECTION
AUTOMATIC SHUTOFF DEVICE AND BALL FLOAT VALVE
Facility Name:Owner:
Address:Address:
City, State, Zip Code:City, State, Zip Code:
Facility I.D. #:Phone #:
Testing Company:Phone #:Date:
This data sheet is for inspecting automatic shutoff devices and ball float valves. See PEI/RP1200 Section 7 for inspection procedures.
Product Grade
Tank Number
Tank Volume, gallons
Tank Diameter, inches
Overfill Prevention Device Brand
Type Automatic
Shutoff Device
Ball Float
Valve
Automatic
Shutoff Device
Ball Float
Valve
Automatic
Shutoff Device
Ball Float
Valve
Automatic
Shutoff Device
Ball Float
Valve
Automatic
Shutoff Device
Ball Float
Valve
Automatic
Shutoff Device
Ball Float
Valve
AUTOMATIC SHUTOFF DEVICE INSPECTION
1. Drop tube removed from tank? Yes No Yes No Yes No Yes No Yes No Yes No
2. Drop tube and float mecha-
nisms free of debris? Yes No Yes No Yes No Yes No Yes No Yes No
3. Float moves freely without
binding and poppet moves into
flow path?
Yes No Yes No Yes No Yes No Yes No Yes No
4. Bypass valve in the drop tube
open and free of blockage (if
present)?
Yes No
Not Present
Yes No
Not Present
Yes No
Not Present
Yes No
Not Present
Yes No
Not Present
Yes No
Not Present
5. Flapper adjusted to shut off
flow at 95% capacity?* Yes No Yes No Yes No Yes No Yes No Yes No
A “No” to any item in Lines 1-5 indicates a test failure.
BALL FLOAT VALVE INSPECTION**
1. Tank top fittings vapor- tight
and leak-free? Yes No Yes No Yes No Yes No Yes No Yes No
2. Ball float cage free of debris? Yes No Yes No Yes No Yes No Yes No
3. Ball free of holes and cracks
and moves freely in cage? Yes No Yes No Yes No Yes No Yes No Yes No
4. Vent hole in pipe open and
near top of tank? Yes No Yes No Yes No Yes No Yes No Yes No
5. Ball float pipe proper
length to restrict flow at 90%
capacity?***
Yes No Yes No Yes No Yes No Yes No Yes No
A “No” to any item in Lines 1-5 indicates a test failure.
Test Results Pass Fail Pass Fail Pass Fail Pass Fail Pass Fail Pass Fail
Comments:
* Use manufacturer’s suggested procedure for determining if automatic shutoff device will shut off flow at 95% capacity.
** If a ball float is found to fail the inspection, another method of overfill must be used.
*** Use manufacturer’s suggested procedure for determining if flow restriction device will restrict flow at 90% capacity.