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U LTRAZOL®GA9058 (OS634188E) <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />kAs require a Dy reaerai Kegulation ul-K <br />I itle 4U, uniapter 1, Subchapter 1, Part 280.32 <br />b)91)(ii) <br />Manufacturer s <br />()T <br />(including prior <br />marketed names) <br />Model <br />Component <br />e <br />Type <br />(i.e. pipe, <br />tank, etc.) <br />Current <br />UL <br />Standard <br />Listing <br />Years of <br />Manufacture <br />Sizes <br />Unique <br />Identifiers for <br />Field Evaluation <br />(i.e. color, material) <br />Blend <br />Concentration <br />Supporting <br />Test Data & <br />Documents <br />Attached <br />Yes/No <br />Jomar <br />Valve <br />T -SS -1001 N <br />100-964yellow <br />Ball Vavle <br />YES <br />%11 <br />SS, '/4 turn, <br />handle <br />=� <br />o <br />r Ui canna anu tnNngy Nicaac ubt vi uy uUuvlC wail PlUUUL t5 <br />Manufacturer: <br />Corporate: <br />Headquarters: <br />Address: <br />Phone: <br />Email: <br />Jomar Valve <br />7243 Miller Dr <br />Warren, MI <br />586-268-1220 <br />csr@jomar.com <br />unser: a company logo below it available) <br />•,omar <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 />Rick Rank Engineering Manager <br />Print Nam <br />Ntmnufacturer's `Authorized Signature <br />Title <br />Date <br />=. <br />Z <br />� <br />N <br />=� <br />o <br />r <br />