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Q,1STRUCTIONS FOR COMPLETING FOR "C": TANK INSTALLATION E TIFI TI N <br /> GENERA"I" INSTRUCTIONS <br /> rds, sl."Vstern mut be in compliancewith the federal and state technical <br /> ,inidarrd G contained in law and regE,flations, for teak and piping installation. <br /> 2. This certification shall te completed by either the UST owner or representative. <br /> 3 One certification is rept lr d for each tisk system. This form shall be used to <br /> ranks tht,� required c rtlti ti n, <br /> 4;: P*r ;e type or print clearly all requested i for tion (for prinfin . please use <br /> R ms Lan <br /> aom.P'Medi cnenfification to the appropriate Local Implementing Agency. <br /> ti. ,sl f, It,tlt, MARK ALL. OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS T E MET. <br /> RANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br /> i.11 f r,'10ATI f °ll HE INFORMATION PROVIDED EI IS TRUE AND <br /> ("'�t PE'CT, THE E EE SO ' NAME SHOULD BE PRINTED UNDER THE <br />