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by CA Supplemental Information <br /> Site Number L Date 2' <br /> ATG PROBES VENT PIPING VAPOR RETURN PIPING <br /> Tank# Manufacturer/Model Material of Construction Material of Construction INTERSTITIAL Sensor <br /> DWF=OW Fiberglass DWF=DW Fiberglass <br /> SWF=SW Fiberglass SWF=SW Fiberglass <br /> Order per Write Manufacturer&Model SWS=SW Steel SWS=SW Steel Write Manufacturer&Model <br /> tank monitor Number in the space provided DWFLX=OW Flexible DWFLX=DW Flexible Number in the space provided <br /> SWFLX=SW Flexible SWFLX=SW Flexible <br /> UNK=Unknown UNK=Unknown <br /> 2 ��L%0 Lo til G33ZllZ rc,� <br /> 3 <br /> 4 RED <br /> 5 F rB 0 7 19 <br /> iHEALTH <br /> ADDITIONAL TANK SENSORS-VPH SI <br /> Product PIpI Vent Piping <br /> Tank# STPJPEping Sump FIII Sump <br /> INTERSTITIAL Sensor INTERSTITIAL Sensor INTERSTITIAL Sensor INTERSTITIAL Sensor <br /> Order per Write Manufacturer&Model Number in the space provided <br /> lank monitor <br /> NA=No Sensor <br /> 1 - ,> 1 <br /> 1 / <br /> C, t J C i ' <br /> 2 0 321tl 02( a z u7 <br /> 4 1JQYl 60/ is r I <br /> 5 <br /> ADDITIONAL DISPENSERS SENSORS-VPH SITES ONLY <br /> UDC <br /> UDC <br /> Dispenser# INTERSTITAL Sensor D(spenser# INTERSTITAL Sensor <br /> Write Manufacturer&Model Number in space Vl.'nle Manufacturer&Model Number in space provided <br /> Dispenser# provided Dispenser# <br /> NA=No Sensor NA=No Sensor <br /> 1/2 9/10 <br /> 3/4 11/12 <br /> 5/6 ,u 3� �I 13/14 <br /> L 3-- 15/16 <br /> issued 01/12/2019 Additional Page <br />