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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of pians & applications as originals will be retained by EHD) <br />7 Site map enclosed? YES[] NO pq <br />2- Submit poples of iCC Service Technician and/or Installees certificate and all manufacturer training certificates for <br />eachperson installing or testing any component that is <br />and Safety Plan' is available on the - repaired or replaced- Ensure a copy of the "Site Health <br />JOb51te as required by Title S. <br />3- Detailed description of work to be completed. List components <br />drawn to scale showing location of repairs and/or replacements. to be repaired or replaced and attach a diagram <br />be done- I# addi cements. If repairing a component, describe how this will <br />{ " % piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST <br />Installation Application pages 4-8 as necessary for a timely plan rev1ew), <br />Replaced L23 sensor. L23 is the disperser pan secondary containment sensor. We replaced with same <br />sensor. <br />4_ List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />Veeder-Root 0794380-304 <br />