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May 19 14 11:14a Elite IV Contactors 120946.JXpMT5,2 <br />Ir„ wry: <br />k <br />Csyy 1 . <br />/ 3 <br />CONTRACTOR LICENSE # 4M, .ICC CERTIFICATION i f <br />I certify that the information, provided heirdn 'is true; accurate;. rind thatthe &llovi'in4 auditions have been satisfied: <br />• ° The installer has met the r quzements set fortb.in 23 CCR §2715, subdivisions (g) and i.). <br />• The underground storage tank, any primary Piping, and any, secondary containnie t was installed according to applicable <br />voluntary consensus standards and any..manufacturer's written installation instructiolL.. . <br />®. All work fisted in the mamlfacturer's installation checklist has been completed: <br />• The installationhas`been inspected and. approved by the local. agency; or..,.if required b, the IocaT agency, inspected and certif�ecl <br />b a ce istered rofessioxtal ` e Navin education and a ricticewith inder ' ount Stora tank stcM installations. <br />SIGMA FTA O 23t WNER S AOEN F .. DATE' ase PHONE eaa. <br />NARK <br />Cly&'C't'�cti C <br />NAA0 Of CE�WM <br />R'5 EMPL <br />gO <br />�YER (DBA) a a CERTiF]ER'S REI ATIOTI iI PTO TANK OWNER :. 489. <br />t ` C, 1 '- C:S..' �1�F' Q (Ci { 1� a � .1 TtYIJiC OWNER .. ] 2. Tiai3+TIEtSPERATOR <br />®3 CONTRACTOR: ❑ 4. PROPERTY OWNER <br />0 S: onuRAUTHORIZEI .GENT OF'i°ANX OWNER <br />a. UPCF UST -C Res'. (I2/2007) . 112 <br />