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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES [) NO [� <br />2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br />person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health andoSafety <br />Plan" is available on the jobsite as required by Title 8. <br />3. Detailed description of work to be completed. List components to be repaired or replaced and attach a diagram drawn <br />to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be done. (if <br />adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a timely plan review): pp <br />kA —A: -C. 'R ,r -t,,, 1(_,%y1 .r.Ci0^ (pan c" G_r t-,- ctP+Ofoaak %�. Oralrn <br />(SUP �b "b ji :iC6tilari,f°'ir.1.1 6o)n InGtk- <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />/I -V C, <br />i <br />i <br />K <br />