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0 <br />LT ® Tang Page <br />(Note: the numbering of the instructions follows the data element numbers that are on the !,PPCF pages. These data <br />element numbers are used for electronic submission and are the same as the numbering used in 27 CCR, Appendix C, <br />the Business Section of the Unified Program Data Dictionary.) <br />Meese number all pages of your submittal. This helps your CUPA or local agency identify whether the submittal is <br />complete and if any pages are separated. <br />456. PIPING SYSTEM TYPE (UNDERGROUND) R For items 456 and 459,`check the tank's piping system <br />459. PIPING SYSTEM TYPE (ABOVEGROUND) information, CHECK ALL THAT APPLY. <br />460. PIPING CONSTRUCTION (UNDERGROUND) - Check the teak's piping construction information. CHECK ALL <br />THAT APPLY, <br />461, PIPING MANUFACTURER (UNDERGROUND) - Enter the nerve of the piping manufacturer. <br />462. PIPING CONSTRUCTION (ABOVEGROUND) s Check the tank's piping construction information. CHECK ALL <br />THAT APPLE''. <br />463. PIPIT MANUFACTURER (ABOVEGROUND) - Enter the name of the piping manufacturer. <br />464. PIPING MATERIAL AND CORROSION PROTECTION (UNDERGROUND) - For items 464 and 465, check the <br />465. PIPING MATERIAL AND CORROSION PROTECTION (ABOVEGROUND) tank's piping material and corrosion <br />protection. <br />466. PIPING LEAD DETECTION (1,1NDERGROUND) - For items 466 and 467, check the leak detection system(s) used <br />467. PIPING LEAK DETECTION (A OefFi.�ROUND) to comply with the monitoring requirements for the piping. <br />466. DATE DISPENSER CONTAINMENT INSTALLED - If applicable, enter the date that dispenser containment was <br />installed. <br />469. DISPENSER CONTAINMENT TYPE m Check the type of dispenser containment monitoring system. <br />SIGNATURE OF OWNERIOPERATOR - The owner or agent of the owner shall sign in the space provided. This <br />signature certifies that the signer believes that all the information submitted is true and accurate. <br />470. DATE CERTIFIED - Enter the date the page was signed. <br />471. OWNER/ OPERATOR NAM - Print the name of signatory. <br />472. OWNER/ OPERATOR TITLE - Enter the title of the person signing the page. <br />473. PERMIT NUMBFP - Leave this blank, this number is assigned by the CUPA. <br />474. PERMIT APPROVED BY - Leave this blank, this is the name of the person approving the permit. <br />475. PERMIT EXPIRATION DATE m Leave this blank, this is completed by the CUPA. <br />UPCF (121199 revised) 13 T"omierly SWRC 3 Form B <br />