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0 • <br /> UST SYSTEM RETROFIT OR REPAIR R <br /> EL;EIVED <br /> (Submit minimum of 3 sets of plans &applications as originals will be retained by ETG 2 8 2017 <br /> 1. Site map enclosed? YES [] NO [ <br /> 2. Submit <br /> son installing of[CCS Service <br /> Technician and/or <br /> /oris Installer's <br /> or eand all lana a t of t e "Qg"�'AWi 14 �����hTH <br /> copies <br /> P 9 9 Y p p P copy itd-6afth nd 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 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): <br /> cue, &j6_), sty oute,l� *0 <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> SIR 4 a C> 4 S-ULSOI) <br /> EH230038(revised 7-26-2016) 3 <br />