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NfRrWx*M"r,T=40M, at <br />Owner's Name: <br />Owner's Address: <br />City/County: <br />Owner's Phone: <br />Facility Number: <br />ff-liodiesel Blend: B Tank Volume: <br />Leak Detection Equipment <br />Manufacturer <br />Model Manufacturer Written <br />Statement Specific to the <br />Biodiesel Blend Stored or to <br />be Stored? <br />Tank Sensor(s) <br />Tank Sum p/Pi ping Sensor(s) <br />UDC Sensor(s) <br />Transition Sump Sensor(s) <br />Tank Gauge(s) <br />-Automatic <br />Line Leak Detector(s) <br />Tank/Line Testing Equipment <br />Leak detection equipment manufacturer(s) written statement(s) regarding functionality for use <br />with biodiesel as identified above are attached. <br />I hereby acknowledge that the leak detection equipment functions with the biodiesel blend stored <br />or to be stored <br />Signature <br />IM <br />