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Equipment Certification StatemenV <br /> Date: 1202D21 <br /> ME MCompany Nam a, Witk 's Construction- Iric. <br /> 'If thO COWWOF Intends to provide gasoline related services,whether construction w maintenance,this form <br /> must he Completed.The Conlractw might no€be Manufacturer certified to m pair or install all the items listed <br /> below,but must be certified on any+equipmens they do service or inS1,91;.Any equipment the contractor <br /> Claims manutacturer certification shall t uwe the certified person stil l under empEoyment by the Contractor-The <br /> informatfon requested below is required so that the best business prackm and decisions Can be developed by <br /> 7-Eleven. Mc.At 7-Eleven, Inc.at its option, may confirm theinfonnation provided with the any manufacturer <br /> where ceMwtion is claimed. <br /> arson Certified <br /> (most manufacturers do nc4 c2n4 CerL." N°' lff Explraflon <br /> UIiLt �fhn' nICS,i SIiCEyp) ataM <br /> New Construction <br /> Xerxes Tanks Dale Adams- Erik Wil key 81112022 <br /> Fe Petro STP <br /> eeder Root ATO <br /> NOV Fiberglass Systems (AO Smith) Dale Adams. Erik MTey, <br /> including bonded entry fain training Brandon Adams 1!31.12023 <br /> OPW Equipment Unto ro4.md Dale Adams 104641 2114W22 <br /> OP Loo System <br /> 'Healy astern (Stage II Systern if a Iicablel <br /> Fibrelite M8nhole s stems - 7-11 Multi- ort <br /> ilbarco Dis ensers <br /> Oilbaron Passport Systerns <br /> Bravo, Penetrations and vent boxes Dale Adams. Erik Wil key 413412022 <br /> Oma aFlex Piping stems <br /> DEF-Trac Piping terns <br /> Site Upgrades_ En addition to above <br /> Cantainment Solutions. Inc. Tanks <br /> Red ,Jacket STP <br /> OPW Fleworks PiRing s stem <br /> APT Pi ping system <br /> Date Adams, Erik Wilkey. <br /> Ameron Piping Bfandon Adams U3112023 <br /> Dresser Wayne <br /> Western Fiber alas sum ps and U D <br /> Brava Repair boot system Date Adams, Erik Wilke 4,130 022 <br /> ICON Repair Systerns <br /> POI Sump Lids <br /> rams' <br /> Gilbarco DIS ensen Systems <br /> Dresser Wayne Dispenser Sy5tems <br /> The information!answers to the foregoing questlons and a1E statements therein contained are true <br /> anCf rorreCt- Falsification of information!answer is subj¢ o disqualification. <br /> Submitted Fay- <br /> Title- Supervisof <br />