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0 <br />Formerly SWRCB Form B UST -Tank Page 2 <br />(Note: the numbering of the instructions follows the data element numbers that are on the UPCF 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 />Please 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 />458. PIPING SYSTEM TYPE (UNDERGROUND) - For items 458 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 tank=s piping construction information. CHECK ALL <br />THAT APPLY. <br />461. PIPING MANUFACTURER (UNDERGROUND) - Enter the name of the piping manufacturer. <br />462. PIPING CONSTRUCTION (ABOVEGROUND) - Check the tank=s piping construction information. CHECK ALL <br />THAT APPLY. <br />463. PIPING 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 LEAK DETECTION (UNDERGROUND) - For items 466 and 467, check the leak detection system(s) used <br />467. PIPING LEAK DETECTION (ABOVEGROUND) to comply with the monitoring requirements for the piping. <br />468. DATE DISPENSER CONTAINMENT INSTALLED - If applicable, enter the date that dispenser containment was <br />installed. <br />469. DISPENSER CONTAINMENT TYPE - Check the type of dispenser containment monitoring system. <br />SIGNATURE OF OWNER/OPERATOR - 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 NAME - Print the name of signatory. <br />472. OWNER/ OPERATOR TITLE - Enter the title of the person signing the page. <br />473. PERMIT NUMBER - 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 - Leave this blank, this is completed by the CUPA. <br />UPCF (1/99 revised) 13 Formerly SWRCB Form B <br />