0011 HAWTHORNE - Burner Installation Form 24 Power Burners
REPLACED TANK ONLY
Date
Name Mike O' Connor
Location 11 Hawthorne No. of Tanks 1
Name of Burner Mass. Approval No.
Gals. Stored 275 Kind of Heat
Location of Tank Basement Kind of Oil
Installed by Gill Service C. of C. # 017145
Inspected by Date Approved