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TANK INSTALLATION CHECKLIST <br /> SITE SKETCH(Indicate specifics of tank installation.) ADDITIONAL NOTES <br /> _ Note any variations and/or deviations from <br /> � instructions(and attach written authorizations): <br /> fu <br /> Q <br /> Clvt�1 7D, <br /> 3 <br /> 1 ; <br /> VERIFYING SIGNATURES <br /> CONTRACTOR TANK OWNER/REPRESENTATIVE <br /> I verify that this information is a true record of the installation of the tanks I verify that this information is a true record of the installation of the tanks <br /> listed here. , listed here,and that I have received a copy of the Installation Manual <br /> A)STRUCT7(j tAjQ and thisTank Installation Checklist. <br /> Name PAt._._..__.��a p� S Name: <br /> Telephone S'30 - � Z 23 3.___..._ __- _ Telephone: <br /> Email: c�a'e Ce�SCornS 1-fa cb7c,v Email: <br /> Address: Address: <br /> (4557 ,Skyway Dr, 011vehH,ev+, Gf qPW <br /> Sign re: Signature: <br /> Date: S -17- / Date: <br /> TO INSTALLER:After tank installation,deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner.Retain a copy of <br /> each for your records. <br /> TO OWNER:After installation,retain the limited warranty,the Installation Manual and completed Tank Installation Checklist for future reference and to <br /> facilitate any warranty claim. <br /> L G . ,/K W IMOG1119PP 43 <br />