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INSTRUCTIONS FOR JVLETING FORM "C": TANK INSTALL)ON CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Ea--h to, k systvern must be in compliance with the fair and state technical <br /> standards, contained in law and regulations, for an and piping Installation. <br /> 2> This certification shall be completed by either the UST owner or representative. <br /> 3. One certification is required for each tank system, This form shall be used to <br /> make the required �,,,ertfficanon. <br /> 4. Please type or print clearly all ,requested information (for printing, please use a <br /> hard point writing instrument), <br /> 5. Submit the completed certification to the appropriate Local Implementing Agency. <br /> I. INSTAL TION. MARK ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIRENIENTS ARE MET. <br /> [L OATH: THM TANK OWNER 05"1 AGENT SHALIL, CEIRTIFY, BY SIGNINC31 TIFIIA <br /> CERTIFICATION, THA TTHE INFORMATION PROVIDED IS 'TRUE AND <br /> CORRECT, THE PERSON'S NAME SHOULD BE PRINTED UNDER THE <br /> SIGNATURE. <br />