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I SRI TI S FOR COMPLETING FORN1 "C": TANK 4N'ST LL TI _N CERTIFICATION <br /> GENERAL INSTRUCTIONS <br /> I. Each tank system mut ibe in compliance .'SIT; the federal and state technical <br /> standards, contained in law and regulations, for teak and piping installation. <br /> . This certification shall be completed by Other the DIST owner or representative, <br /> One certification is required for each. tarl,.". This form shall be used to <br /> asks the required c rtif c ton. <br /> Please type or print clenily requested yr''rm tion {for printing} please use a <br /> hard pent writing int ient), <br /> S. Submit the completed iliii. tion to the appropriate Local Implementing Agency. <br /> 1. INSTALLATION: MARl ALL OF THE ITEMS THAT APPLY TO INDICATE THAT THE <br /> INSTALLATION REQUIREMENTS ARE MET. <br /> It. TN. THE TANK OWNER OR AGENT SHALL CERTIFY, BY SIGNING THE <br /> CERTIFICATION, THAT THE INFORMATION PROVIDED IS TREE AND <br /> CORRECT. : THE PERSON'S NAME SHOULD PRINTED UNDER THE <br /> SIGNATURE. <br /> 1 <br />