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�iP4'°"`r' T�.�';t'aw '+m` ?.'!'.Z���'1.";T/.' ��. _. +M^. ...:1.''kS'P " A',rb^"'�g'��-�h'�ti''.^•'.'.:-��U��c �i'�q., - <br /> INSTRUCTIONS FOR COMPLETING FORM "C": TANK INSTALLATION CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> 1. Each tank system mast be in compliance with the federal and state technical <br /> standards, contained in law and regulations, for tank and piping installation. <br /> This certification shall te completed by either the UST owner or representative. <br /> 3, One certification is reqs.ired for each tank system. This form shall be used to <br /> make the required cerMication. <br /> 4. Please type or print clearly all requested information (for printing, please use a <br /> Lard point writing instrument). <br /> 5f, Subnaft the completed certification to the appropriate Local Implementing Agency. <br /> I, <br /> INS TALtATION. MARK. ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION N REQUIREMENT ARE MET. <br /> lI, 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 RE PRINTED UNDER THE <br /> SIGNATURE. <br /> • <br />