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ULTRAZOL®GA9058 <br />Manufacturer's Affirmative Statement of Compatibility <br />(As required by California Code of Regulations section 2631(k)) <br />(As reauired by Federal Regulation CFR Title 40. Chapter 1. Subchapter 1. Part 280.32 (b)91)(ii)) <br />Manufacturer(s) <br />(including prior <br />marketed names) <br />Model <br />Component Current <br />Type UL <br />(i.e. pipe, Standard <br />tank, etc.) Listing <br />Years of <br />Manufacture <br />Unique <br />Sizes Identifiers for Blend <br />Field Evaluation Concentration <br />(i.e. color, material) <br />Supporting <br />Test Data & <br />Documents <br />Attached <br />(Yes/ o) <br />OPW <br />FL -100 <br />MANHOLE Y <br />10 <br />37" BLACK <br />OPW <br />1C -2100C <br />SPILL Y <br />30 <br />5 GAL ALUMINUM <br />OPW <br />1DP-2100 <br />PLUG Y <br />30 <br />1" WHITE <br />OPW <br />FSA -400 <br />ADAPTER Y <br />20 <br />4" BLACK <br />Edward Kammerer <br />OPW <br />1612 -AN -0200 <br />ADAPTER Y <br />30 <br />2" ALUMINUM <br />OPW <br />63413-0160 <br />CAP Y <br />30 <br />2" GREY <br />OPW <br />61 Fstop-2000 <br />OVERFILL Y <br />30 <br />2" BLACK <br />OPW <br />61 FT -0206 <br />TUBE Y <br />30 <br />2" BLACK <br />Manufacturer's Authorized Signature <br />OPW <br />C075A <br />PIPING Y <br />25 <br />3/<" BLUE <br />OPW <br />REF -4020 <br />ENTRY Y <br />10 <br />4" BLACK <br />OPW <br />SBC -2075 <br />FITTING Y <br />15 <br />3/<" BLACK <br />OPW <br />VPN4X7 <br />PIPE NIPPLE NA <br />20 <br />4" BLACK <br />For tanks and piping please list only double wall products (Insert a company logo below if available) <br />Manufacturer: OPW Fueling Components <br />Corporate: Dover Corp <br />Headquarters: Smithfield, NC <br />Address: 3250 Highway 70 Business West <br />Phone: 513-870-3100 <br />Email: ed.kammerer@opwglobal.com <br />I declare, to the best of my knowledge and belief, that this affirmative statement of compatibility and the information coi5ained herein is true, <br />correct, and complete. <br />�_ <br />N <br />Edward Kammerer <br />Director of Marketing and Global <br />r, <br />Product Strategy j <br />Print Name <br />Title <br />1 <br />N <br />N <br />Date 4/14/2023 = = <br />C <br />Manufacturer's Authorized Signature <br />1/2023 <br />