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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans 8 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 and Safety <br /> Plan"is available on the jobsitc 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 or 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 /> r— ----------- ------- <br /> h. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> 2 <br /> 2 'd 24139194602 OUI 5.aozoej,4uo3 nI 01113 CIES :21 60 60 -tew <br />