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1California Delpartment of Foram" & Fire Protectlor Office VAPOR RECOVERY L[qi'weyk Certification No. GVRC 005:053:029 *Revised November 15, 2007 Page 1 of 1 VAPOR RECOVERY CLEAN AIR SEPERATOR USTEE— Franklin Fueling Systems, 3760 Marsh Road, Madeon, WI 53718 DESIGN— The Healy System Models 961 and *9W1 H Clean Air Separator tank Is designed for use at a gasoline d sing It is used in cordunt$km with e product storage tank system and will contain up to approximately 400 gallons (5W) of excess gasoline vapors, thus preventing their release to the atmosphere. At a later time, when the tank system is under a negative pressure condign, the stored vapors aro returned to the product storage area. The system contains no moving or electrical parts and is Installed in close proximity to the product storage tank vent system in accordance with NFPA 30A, Chapter 10. designed to work with a Healy Systems assist vapor recovery system with limier air velum ne return fueling ORVR equipped vehicles, The Models *M1 and *9951 H can work with any vat recovery system that may have periodic eplsaies of excess vapors. INSTALLATION—The tank Installation Is done in accordance with manufacturer's installation Instructions. 'The Model 9981 is intended for vertical Installation. `The Model 9961H Is Intended for horizontal installation. The units are Intended to be Installed using California State Fire Marshal Cartilled and compatible Vapor Recovery System Component Parts: Such as nozzles, hoses, breakaway value, vacuum sources and hose adapters. The installer is responsible for ensuring compatibility of component parts and current California State Fire Marshal Certification. MARMNG— Llstee's name, model number, and UL Mark shall appear on a label adhered to the side of the tank in accordance with UL instructions. CERTIFICATION—The Healy System 1 and 1H are cartilled for use at retail and commercial motor final dispensing, full orself-service, facilities where vapor recovery equipment is desired or required by raw. This certification Is made pursuant to the authority granted to the California State Fire Marshal as contained In Sections 41955 through 41980 Inclusive, California Health and Safety Code. The certification is based upon independent tests or other technical data submitted by the applicant. CSFM staff hes reviewed the test results and/or other data but does not make an Independent verification of any claims. This certification is not an endorsement or recommendation for the use of the Item(s) specified. This certification should not be used to verify correct operational requirements or Installation criteria. ISSUED: DECEMBER 5, 2007 AUTHORIZED BY: James Parseglan, Supervising Deputy State Fire Marshal Vapor Recovery Program