HomeMy WebLinkAbout12727 003964 101 12-16-2020 OFINP SLA OVERFILL INSPECTION 66068.52 OFINP
ADEM
3 YEAR OVERFILL PREVENTION EQUIPMENT INSPECTION REPORT
Facili Name: United Food and Fuel#14 Owner: McNeill Family
Address: 1192 Western Blvd. Address: PO Box 11
City, County,Zip: Montgomery, Montgomery, 36108 Cit , State,Zi : Montaomerv.AL 36101
Facility I.D.#: 12899-101-003964 Phone#: 334-263-6523
Inspector Name: Kurtis Waiters Inspector Phone#: 4- 4
Inspector Company: Inspection Date: 12-1 -2
Instructions
1. Submit a completed copy of this form within 30 days of performing test to: Groundwater Branch,PO Box 301463,Montgomery,AL
36130-1463,or fax to: (334)270-5631,or email to: USTcomoliancera3adem.alabanni .
2. If two or more types of overfill devices are present,only complete portion of form pertaining to the primary overfill device.
3. Inspection must be performed in accordance with a nationally recognized code of practice(such as PEI RP-1200 or equivalent)or the
manufacturers instructions.
4. Keep a copy of this inspection for 3 years. Questions on how to complete this form should be directed to the Groundwater Branch,
UST Compliance Section at(334)270-5655.
ADEM Unique Tank# 1 1 2 1 3
Product Stored Gasoline Gasoline Diesel
Primary device being used in each ❑Auto Shutoff ❑Auto Shutoff ❑Auto Shutoff ❑Auto Shutoff ❑Auto Shutoff
tank to prevent overfill (Record only ❑Alarm ❑Alarm ❑Alarm ❑Alarm ❑Alarm
primary device inspection results.) ® Ball Float 91 Ball Float I ® Ball Float ❑ Ball Float ❑Ball Float
Was primary overfill device ID yes MI yes Ul yes ❑yes ❑yes
removed for test? ❑ no ❑no 1 ❑no ❑no ❑no
Automatic Shutoff Device Inspection
Drop tube and float free of debris? 0 yes ❑yes ❑yes ❑yes ❑yes
❑ no ❑no ❑no ❑no ❑no
Float moves freely and poppet ❑yes ❑yes ❑yes ❑yes ❑yes
moves into path of flow? ❑ no ❑no ❑no ❑no ❑no
Bypass valve free of blockage? 13 0 no ❑no ❑no ❑no ❑no
(where applicable) 0 n1a 0 n/a 0 n/a 0 n/a 0 n/a
Flapper adjusted to shut off flow at ❑yes ❑yes ❑yes ❑yes ❑yes
95%or less capacity? ❑ no ❑no ❑no ❑no ❑no
High Level Alarm Ins ection Outside Near Tanks,Not Inside at Tank Monitor
Overfill alarm activates in test ❑yes ❑yes ❑yes ❑yes ❑yes
mode at console? ❑ no ❑no ❑no ❑no ❑no
Alarm can be heard and/or seen ❑yes ❑yes ❑yes ❑yes ❑yes
from where the tank is filled? ❑ no ❑no ❑no ❑no ❑no
All associated floats move freely? 0 yes ❑yes ❑yes ❑yes ❑yes
❑ no ❑no ❑no ❑no ❑no
Alarm activates at 90%or less ❑yes ❑yes ❑yes ❑yes ❑yes
capacity? ❑ no ❑no ❑no ❑no ❑no
Ball Float Valve Inspection
Ball float cage free of debris? Z yes El yes ®yes ❑yes ❑yes
❑ no ❑no ❑no ❑no ❑no
Ball moves freely in cage and is KI yes 10 yes ID yes ❑yes ❑yes
free of damage? ❑ no ❑no ❑no ❑no ❑no
Vent hole in pipe is open and near III yes 91 yes KI yes ❑yes ❑yes
the lop of the tank? ❑ no ❑no ❑no ❑no ❑no
Ball float pipe is proper length to 91 yes ID yes 91 yes ❑yes ❑yes
activate at 90%or less capacity? ❑ no ❑no ❑no ❑no ❑no
Tank top fittings are vapor tight IH yes ®yes KI yes ❑yes ❑yes
and free of leaks? ❑ no ❑no ❑no ❑no ❑no
Inspection Results for Automatic Shutoff Device or High Level Alarm or Ball Float Valve
Results of Inspection: ®pass ® pass 0 pass '3 pass O pass
('No'answer to any item indicates fail.) 0 fall 0 fail 0 fall 0 fall 0 fall
Repairs Needed Date of Repair Description of any Repairs,
Tester's Signature: Kurtis Wailes
ADEM Forth 559 03/18 m2(revised 8/19)