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U LTRAZO LOGA9058 <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />(As required by Federal Regulation CFR Title 40, Chapter 1, Subchapter 1, Part 280.32 (b)91)(ii)) <br />For tanks and piping please list only double wall products <br />(Insert a company logo below if available) <br />VEEDER-ROOT <br />Manufacturer: Veeder-Root <br />Address: 125 Powder Forest Drive <br />Simsbury, CT 06070 <br />Phone: 916 715-9400 <br />Email. demmington@veeder.com <br />I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true, <br />David Emmington <br />Print Name <br />Man rer's Authorized Signature <br />Environmental Product Manager <br />Title <br />� 2-9,I 3 <br />Date <br />r-. <br />z <br />i <br />Supporting <br />Manufacturer(s) <br />Component <br />Type <br />Current UL <br />Years of <br />Unique Identifiers for <br />Blend <br />Test Data & <br />(Including prior <br />Model <br />(i.e. pipe, <br />Standard <br />Manufacture <br />Sizes <br />Field Evaluation (i.e. <br />Concentration <br />Documents <br />marketed names) <br />tank, etc.) <br />Listing <br />�~} <br />-- <br />color, material) <br />d <br />Attached <br />Yes/No <br />Veeder-Root <br />859080-001 <br />Line Leak <br />N/A <br />N/A <br />N/A <br />None <br />100% <br />No <br />848480-001 <br />Detector <br />Veeder-Root <br />846397-601 <br />Inventory <br />N/A <br />N/A <br />4' <br />None <br />100% <br />No <br />Probe <br />Veeder-Root <br />857280-100, 200, 30x <br />Vacuum <br />N/A <br />N/A <br />N/A <br />None <br />100% <br />No <br />330020-4xx or <br />Sensor <br />332175-001 <br />Veeder-Root <br />0794380-323 <br />Sump Sensor <br />N/A <br />N/A <br />N/A <br />None <br />100% <br />No <br />Veeder-Root <br />0857080-111 <br />Sump Sensor <br />NIA <br />N/A <br />12" <br />None <br />100% <br />No <br />0857080-112 <br />24" <br />For tanks and piping please list only double wall products <br />(Insert a company logo below if available) <br />VEEDER-ROOT <br />Manufacturer: Veeder-Root <br />Address: 125 Powder Forest Drive <br />Simsbury, CT 06070 <br />Phone: 916 715-9400 <br />Email. demmington@veeder.com <br />I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true, <br />David Emmington <br />Print Name <br />Man rer's Authorized Signature <br />Environmental Product Manager <br />Title <br />� 2-9,I 3 <br />Date <br />r-. <br />z <br />i <br />N <br />N <br />correct, and:4,d0iplet- <br />Com: <br />r <br />o <br />h <br />CD.01 <br />w <br />�~} <br />-- <br />d <br />4/2023 <br />