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UST System Affirmative Statement of Compatibility - Page 3 of 4 Manufacturer Model or Part Year Compatibility With the Specific Product Name number Manufactured Stored Has Been Demonstrated B ❑ Third -party approval (e.g.. UL listing) for use with Transition Sum P this specific fuel. NA NA NA ❑ Manufacturers Affirmative Statement ofCompati- bility posted on SWRCB website. ❑ Manufacturer's Affirmative Statement of Compati- bility submitted with this forth. Third -party approval (e.g., UL listing) for use with Penetration Fitting g this specific fuel. Bravo FF Series 2014 ❑D Manufacturer'sAffirmative Statement ofCompati- bility posted on SWRCB website. ❑ Manufacturer's Affirmative Statement of Compati- bility submitted with this form. Third -party approval (e.g., UL listing) for use with Penetration Fittino❑ h this specific fuel. Environ (2 Auto UDC) 2000 ❑ ManupotedonSWRCBweturers Affirmative bs�itteementofCompati- bility ❑ Manufacturers Affirmative Statement of Compati- bility submitted with this form. approval (e.g., UL listing) for use with Penetration F ittino[3Third-party h this specific fuel. ❑ Manufacturer's Affirmative Statement of Compati- bility posted on SWRCB website. ❑ Manufacturer's Affirmative Statement of Compati- bility submitted with this form. ❑ Third -party approval (e.g., UL listing) for use with Penetration Fitting Fitting this specific fuel. ❑ Manufacturer's Affirmative Statement of Compati- bility posted on SWRCB website. ❑ Manufacturces Affirmative Statement of Compati- bil ity submitted with this form. ❑ Third -party approval (e.g., UL listing) for use with Other Component(s) That May Contact Stored Product this specific fuel. OPVV Emergency Shut Off Valve 9 Y 10 Series Various D Mlitypo tedonSurees ffirmativeStitementofCompati- bility posted on SWRCB website. ❑ Manufacturer's Affirmative Statement of Compati- bility submitted with this form. Q Third -party approval (e.g., UL listing) for use with Other Component(s) That May Contact Stored Product this specific fuel. FE Petro Turbine STP -5-166-51 Various ❑ Manufacturer's Affirmative Statement of Compati- bility posted on SWRCB website. ❑ Manufacturers Affirmative Statement of Compati- bility submitted with this form. approval (e.g., UL listing) for use with Other Component(s)That Ma Contact Stored Product Y t Third -party this specific fuel. ❑ Manufacturer's Affirmative Statement of Compati- bility posted on SWRCB website. ❑ Manufacturer's Affirmative Statement of Compati- bili submitted with this form. Attach additional page(s) if necessary.] t N-100 N'wiv.unidocs.org 3/4 - 11/16/15