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00) PROBLEM SOLVED D 'ispeosetCoovotsiooEvoluotloofotm <br /> Distributor: Q09Ttkw eSPT ) u XP Purchase Order # : <br /> Name : � �T Go tj Date : <br /> Email : QrR-T . C� A6MIFZC NW1" 1* lk ' CAM Phone : <br /> Existing UDC Sump <br /> I <br /> Ilf not a Bravo - manufactured UDC , what is the make <br /> model ? yFoe <br /> Shallow Pan ® Deep Sump ❑ Quantity `�► / ' 4 �` ;��_ <br /> Number of existing anchor bolts : <br /> �1 Q / <br /> Yes No <br /> Does the existing UDC have a water spl�sh lip? OR ❑ SPtASp up <br /> If yes , how tall is the lip? 3 " <br /> New Dispenser 1 1 Opening 1 <br /> MEASUREMENT SHOULD BE PLUS/MINUS 1 /V <br /> 1 DISPENSER q `�I kkr CO INCHES <br /> LENGTH : ___ + / - 1 /4 " <br /> MANUFACTURER . C <br /> ' l <br /> DISPENSER WIDTH : + / - 1 /4 " <br /> MODEL #: Cf)n E 'G J 005 " INCHES <br /> � If dimensions above are left blank, this request will not be processed and <br /> i will be returned . No Exceptions . <br /> 1 ' THE STATEOF CALIFORNIA PURCHASE OF ADDITIONAL 1 ' 1 REQUIRED <br /> Yes No (IF YES : Retrofit required in California . Retrofit <br /> Does conduit exist within 2 " of inner opening? ❑ OR l plates recommended outside of California . ) <br /> Yes No <br /> Does conduit exist outside the UDC water splash lip? ❑ OR <br /> Is conduit on 1 or 2 ❑ 1 SIDE ❑ if conduit exists on both sides, check this box <br /> sides of vapor panel ? <br /> ❑ 2 SIDE <br /> Sales Order # <br /> .........__ <br /> ---- FOR ASSISTANCE , CALL BRAVO AT 800 . 282 . 7286 <br /> Existing # ___ New # OR EMAIL TO ORDERS@SBRAVO,COM <br /> Innovative1 1ns for SecondaryContainment <br /> www . sbravo . com800428297286 <br />