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L L®G 9058 ( OS634188E ) <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 /> Component CurrentUnique Supporting <br /> Manufacturers ) Type UL Years of Identifiers for Blend ! Test Data & <br /> (including prior Model I yp I Sizes Documents <br /> marketed names) i (i .e. pipe, i Standard ! Manufacture Field Evaluation Concentration F attached <br /> tank, etc- } I Listing s (i .e. color, material) I (yes/No <br /> Jomar T-SS- 1001 N I Ball Vavle YES 3/4'= SS 1/d turn _ � _ <br /> , <br /> Valve X100-964 ) _ ellow handle <br /> _ — <br /> For tanks <br /> andp' g� to <br /> P please list only double wail products ( Insert se _ <br /> a company logo below if available) <br /> Manufacturer: .iornar Valve <br /> Corporate. 7243 Miller Dr <br /> Headquarters: Warren , MI APMEM <br /> Address : 090mexvs <br /> Phone : 58&2138- 1220 VALVE <br /> Email : csr@jomar.com <br /> 1 declare , to the best of my knowledge and belief, that this affirmative statement of compatibility and the information contained herein is true , <br /> correct, and complete. <br /> Rick Rank Engineering Manager <br /> Print Nam Title <br /> nufacturer' s `Authorized Signature Date <br />