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Coll" <br />JERAL INSTRUCTIONS <br />system must be im- e w thledf,,,Tal and state technical <br />contained in law ions. and installation. <br />2. This certificnflor %hall be cornpk_i:!d by eithec, UST owner or representative. <br />1. One certification is required for each tank system. This form shall be used to <br />make the required certification. <br />type or print clearly all requested a <br />iiaia w,)int writing instrument). <br />e <br />limit the completed certification to the appropriate I menting Agency, <br />MARK ALL OF 'THE ITF HEEMS <br />INSTALLATION IFIEQIJIREW <br />TANK OWNER OR AGENT SHAU <br />C,,�,;iTIFICATION, THAT THE INFORMf', <br />ry <br />THE PERSON'S NAME Slit" i i,,, I3 L <br />