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INSTRUCTIONS FOR CALF "NIC FORM T."INK INSTALLAON CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Each tank system musi be In compliance with the federal and state technical <br /> standards, contained ir! law and regulations, for tank and piping installation. <br /> 2. This certification shall be completed by either the UST owner or representative. <br /> ?. One certification is required for each tank system. This farm shall be used to <br /> make the required certification. <br /> 4. Please type'or print clearly all requested information (for printing, phase use a <br /> hard point writing instrument). <br /> 5. Submit the completed cei tification to the appropriate Local Implementing Agency. <br /> 1. INSTALLATION: MARK ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS ARE MET. <br /> 11. OATH: THE TANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br /> CERTIFICATION, THAT THE INFORMATION PROVIDED IS TRUE AND <br /> CORRECT. THE PERSON'S NAME SHOULD BE PRINTED UNDER THE. <br /> SIGNATURE. <br /> III <br /> _ <br />