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TANK INSTALLATION CHECKLIST <br />Note any variations and/or deviations from <br />instructions (and attach written authorizations): <br />'VERIFYIES: <br />NG SIGNATUR <br />„. <br />CONTRACTOR TANK OWNER/REPRESENTATIVE <br />I verify that this information is a true record of the installation of the tanks I verify that this inforntation is a true record of the installation of the tanks <br />listed here. listed here, and thatth3ve received a copy of the Installation Manual <br />and this Tank Installation Checklist. <br />Name: >G C.� i Name: <br />Telephone: Telephone: <br />Email:2ele�ci� c'Tdr��/6r�'/�_�/`GDia'i Email: <br />Address: Address: <br />13 P0 <br />kd- Y'01c G. elj 6q/ <br />Signature: Signature: <br />ate: Date: <br />TO INSTALLER: Aftertank installation, deliver the Installation Manual with the completed Tank Installation Checklist to the tank owner. Retain a copy of <br />each foryour records. <br />TO OWNER: After installation, retain the limited warranty, the Installation Manual and completed Tank Installation Checklist for future reference and to <br />facilitate any warranty claim. <br />XERXESXTIMOG0121PP 3 <br />BY SHAWCOR <br />