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06/04/2009 16: 25 6613933523 CHUCK HILL PAGE 021'16 <br /> 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 M7 NO C <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br /> "Site Health and Safety <br /> person installing or testing any component that is repaired or replaced. Ensure a copy of the <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 andlor replacements. If repairing a component, describe <br /> e the UST nhow stall will <br /> lln be <br /> done, <br /> (If <br /> ddin piping, UDC's, or other UST equipment, or performing tank top upg <br /> on <br /> pages 4-8 as necessary for a timely plan review): r <br /> e,7 <br /> 6-15 <br /> 7 <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> A <br /> 2 <br />