The School Board of Broward County, Florida

Facilities and Construction Management Department

1700 SW 14th Court

Fort Lauderdale, FL 33312 (754) 321-1500

Document 15105b (33 30 03): Contractor’s Request for LP Tank Removal

To:
(Project Manager) / Request No.: / Date:
Project No:
Project Title:
Facility Name:

I hereby certify that I am an officer of the firm or corporation named herein and have been properly authorized to make the following statements concerning the project named above:

1. I am requesting on behalf of the General Contractor that the SBBC have their LP tank vendor contact me to discuss the tank removal requirements for this project.

2. Estimated date of required removal of tank:

3. Size of tank one: Gallons: Size of tank two: Gallons.

4. Tank to be removed: Above ground Below ground

5. LP gas will be used for:

Emergency Generator Gymnasium Hot Water Heater Science Labs Votec Labs

Kitchen Hot Water & Cooking Equipment

Other:

6. This tank is being:

Replaced with a new tank Is not being replaced

Other:

Submitted By:
Company Name & Address: / Signature
Phone: / Title
Distribution
Project Consultant
Contractor
Energy Conservation & Utility Management / Notice to Contractor
Submit this form at least 90 calendar days prior to the requested removal date to allow scheduling and coordination.

The School Board of Broward County, Florida Section 15105b (33 30 03)

[Specifier replace this line with SBBC project number and name] Contractor’s Request for LP Gas Tank Removal

[Specifier replace this line with Project Consultant’s name] [Specifier replace this line with issue date]

((Specifier leave this line)) SBBC Design & Material Standards, rev. April 22, 2010 ECM) Page 1 of 6

The School Board of Broward County, Florida Section 15105b (33 30 03)

[Specifier replace this line with SBBC project number and name] Contractor’s Request for LP Gas Tank Removal

[Specifier replace this line with Project Consultant’s name] [Specifier replace this line with issue date]

((Specifier leave this line)) SBBC Design & Material Standards, rev. April 22, 2010 ECM) Page 1 of 6