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05!22/2009 14: 43 6613933523 CHUCK HILL PAGE 06;'17 <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 e 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 and Safety <br /> Plan" is available on the jobsite as required by Title 8. <br /> 3. Detailed description of work to be completed. List components to he repaired or replaced and attach a cliagram,4rawn <br /> to scale showing location of repairs and/or replacements. If repairing a component, describe how this will be one. (If <br /> adding, piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST Installatio pplication <br /> pages 4-8 as necessary for a timely plan review): <br /> tr-s t o �a.� '-rne.1--p sy, <br /> �CO- Z <br /> 4, List of equipment to be used (Attach m ufacturer's specification sheets showing third-party approval): <br /> z4q <br /> 2 <br />