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Mar 18 11 08:00a Elite Contactors 12094616342 p.l <br />LTNjF D PROGRAM CONSOLIDATFD FC. W PAR] 8 1011 <br />UNDERGROUND STORAGE TANK <br />CERTIFICATION -OF INSTALLATION IN ()DiFICAT ON <br />WORK : _rrHoR= UNDER PERMIT' <br />.(Nurib )c Daft):. :. <br />U:4- [1NUL"KiJiJrrIY-N. vlvanu-gsv=vl <br />!o <br />• 4. 3'OTHER• <br />DESak PTION OF. WORK BEING CERTIFIED <br />r. <br />3 <br />Hxiq <br />CONIRA(.1tJK L{t.CIYJ — —' <br />l-Pz yq <br />K aMONj - <br />1"eerGify that the -inform a tion. provided herein -is true, accurate, and that the �foliowinl; c raditions have.been satisfied: <br />:..: 'The iastaller has met the Isqucrements set forth in Z-CCR:j17i5 :subdt�ris�ons'(g) MCI U. ' <br />:. <br />'Thi..ondergrotmd storage tank, aay primary piping, and -aay secondary contatil> c e .was installed .according to . appIicable <br />consensus-standards.and-anal nmanufactu= s wnttea=iustaiiabiori-instcnction. <br />. At1 work Ilsted.� the manufactjjme ,s.installation cheri:Iist has been completed. <br />The installation has been inspected and.approve8 by the local aaericy, or:if require i)3 the local agency, inspected and certified <br />1.. _, - - . . nFr.�oeerfxihr-watpm.inefaliatinas_ . <br />41& . <br /><. <br />.415. <br />Se Ir C --r- <br />42L ''F F' TO TANK'OWNER r 44V' <br />t (DBA) > � : CERTIFFIERR S:RELATIOAI.� .:. . . <br />t7 <br />�... .. _ WNER." 2TY�fi. oPHI2ATOR <br />rr.a :rniaraetsmk'.' . FI .'PROPERTY OWNER <br />