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ULTRAZOL®GA9058 <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />(As mrmirarl by Farlaral RanlLlntinn (--PP Tit" An r`knnfcr 1 1 E), +')Of) '10 <br />— -1 anu VIFIIIU NiUCOU nay Uiiiy UUUUIC Wdll YIUUU(.;LS <br />Manufacturer: <br />OmegaFlex <br />Corporate: <br />Headquarters: <br />-- Unique --_ <br />-- - <br />Manufacturer(s) <br />610 524 7772 <br />Component <br />Current <br />Identifiers for <br />Suportng <br />TestD Data & <br />(including prior <br />Model <br />Type <br />UL <br />Years of <br />Sizes <br />Field <br />Blend Documents <br />marketed names) <br />c <br />(i.e. pipe, tank, <br />Standard <br />Manufacture <br />►~ <br />Evaluation <br />Concentration Attached <br />C <br />I <br />etc.) <br />Listing <br />— <br />(i.e. color, <br />(Yes/No) <br />i <br />material <br />OmegaFlex <br />DoubleTrac <br />Piping <br />UL971A <br />Since <br />1",1-1/2", 2" <br />SS w/ <br />Up to 10% <br />n/a <br />/UL1369 <br />3/12/2008 <br />Nylon12 <br />i <br />i <br />OmegaFlex <br />DoubleTrac Flex <br />Piping <br />UL2039 <br />Since <br />W, 1", 1-1/2", <br />SS braided <br />Up to 10% <br />' n/a <br />Connectors <br />7/1/2015 <br />2", 3" <br />i <br />— -1 anu VIFIIIU NiUCOU nay Uiiiy UUUUIC Wdll YIUUU(.;LS <br />Manufacturer: <br />OmegaFlex <br />Corporate: <br />Headquarters: <br />Address: <br />451 Creamery Way Exton Pa. 19341 <br />Phone: <br />610 524 7772 <br />Email: <br />brian.breitinger@omegaflex.net <br />tinsert a company logo below it available) <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 />correct, and complete. <br />Print Name <br />41 <br />Manufacturer's Authorized Signature <br />Title <br />Date <br />t- <br />N <br />C <br />/h <br />c <br />h <br />_ <br />tV <br />►~ <br />C <br />I <br />C <br />L <br />h <br />— <br />i <br />1/2023 <br />