Thank you for specifying a UPF tank for your apparatus. Please fill out the form below and print a copy for your records. *The UPF tank serial number is located on the water fill tower of your Poly-Tank.

Fire Department

Address

City/Town

State / Zip

E-mail

Phone

Fax

Tank Serial Number

Truck Manufacturer

Truck Model

Truck Order #

Truck Delivery Date (ex. 2017-08-03)

Issued By: