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Mar 02 09 11 : 21a Elite Iv Contractors Inc 2094616342 p. 2 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sots of plans & applications as originals will be retained by EHD) <br /> 1, Site map enclosed? YES [] NO [I <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br /> person inslalling 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 be repaired or replaced and attach a diagram drawn <br /> to scale showing location repairs and/or replacements. If repairing a component, describe how this will be done. (If <br /> adding piping, UDC's, or ter UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as necessary fo a time)r pla(n�review): <br /> 1__ItlLl _ <br /> 4. List of equipment to be used (Attach manufacturer's specifiCotion sheets showing third-party approval): <br /> �-��G.tom-----_----------^_------ - <br /> 2 <br />