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r <br /> i dFl4 Q <br /> California Department of Forestry & Fire Protection <br /> \ Office of the State Fire Marshal <br /> STATE'r.RE MARSHAL <br /> VAPOR RECOVERY 1 <br /> CERTIFICATION <br /> Certification No. GVRC 5:027:029 <br /> Revised January 31, 2005 <br /> Pate 1 of 1 <br /> CLEAN AIR SEPARATOR SYSTEM (EVR COMPLAINT) <br /> LISTEE--- Healy Systems Inc. 17 Hampshire Drive, Hudson, New Hampshire 03051 <br /> DESIGN—The Healy Systems Model 9942 Clean Air Separator tank is designed for use at a gasoline dispensing <br /> facility. It is used in conjunction with the product storage tank vent system and will contain up to approximately 400 <br /> gallons (53ft) of excess gasoline vapors, thus preventing their release to the atmosphere. At a later time,when the <br /> tank system is under a negative pressure condition, the stored vapors are returned to the product storage area. The <br /> system contains no moving or electrical parts and is installed in close proximity to the product storage tank vent <br /> system in accordance with NFPA 30A. <br /> APPLICATION—While designed to work with a Healy Systems, Inc. assist vapor recovery system with limited air <br /> volume return while fueling ORVR equipped vehicles, the Model 9942 can work with any vapor recovery system that <br /> may have periodic episodes of excess vapors. <br /> INSTALLATION—The tank installation is done in accordance with the manufacturers installation instructions. The <br /> units are intended to be installed using California State Fire Marshal Certified and Compatible Vapor Recovery System <br /> Component Parts: Such as nozzles, hoses, breakaway valves, vacuum sources and hose adapters. The installer is <br /> responsible for ensuring compatibility of component parts and current California State Fire Marshal Certification. <br /> MARKING—Listee's name, model number, and UL Mark shall appear on a label adhered to the side of the tank in <br /> accordance with UL instructions. <br /> CERTIFICATION—The Healy Model 9942 Clean Air Separator is Certified for use at retail and commercial motor fuel <br /> dispensing, full and self service facilities where vapor recovery is desired or required by law. <br /> This certification is made pursuant to the authority granted to the California State Fire Marshal as contained in Sections <br /> 41955 through 41960 inclusive, California Health and Safety Code. The certification is based upon independent tests or <br /> other technical data submitted by the applicant. CSFM staff has reviewed the test results and/or other data but does not <br /> make an independent verification of any claims. This certification is not an endorsement or recommendation for the use of <br /> the item(s)specified. This certification should not be used to verify correct operational requirements or installation criteria. <br /> Issued, AUGUST 30, 2007 Authorized By: James Parsegian, DSFM III Program Coordinator <br />