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TANK INSTALLATION CHECKLIST <br />Note any variations and/or deviations from <br />instructions (and attach written authorizations): <br />V1;RIFYINO;IGNATUkES <br />CONTRACTOR <br />TANK OWNERIREPRESENTATIVE <br />I verify that this information is a true record of the installation of the tanks <br />listed here. <br />I verify that this information is a true record of the installation of the tanks <br />listed here, and that I have received a copy of the Installation Manual <br />and this Tank Installation Checklist. <br />Name: IUCL,14 <br />. C(A <br />Name: <br />Telephone: <br />ephone: <br />Email: _' .&&n„���Qv�u�6(��rainfQya✓rce, <br />mail: <br />Address:9 <br />4* �s�r Gt lvtir o Ca. ln�l� <br />Address: <br />Signature: <br />—&./ /” 1,04,J <br />Signature: <br />Date: /` /'7 T64 <br />Date: <br />TO INSTALLER: After tank installation, deIiverthe Installation Manual with the completed Tank Installation Checklist to the tank owner. Retain a copy of <br />ea ch for yourrecords. <br />TO OWNER: After installation, retain the limited warranty, the Installation Manual and completed Tank Installation Checkl ist for futu re reference and to <br />facilitate any warranty claim. <br />� ® <br />XERXES39 <br />