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UST SYSTENt 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,[]_ ND 11. <br /> --- <br /> 2. Submit_copies oLlCti ServrceSec6nician and[o[Installer's certificate and aIL manufacturer training certificates for <br /> __each-person-installing-or-testing-any-Mmponent-thatisrepairedor-repaired --Ensure-a_copy-of-the-"Site <br /> and Safety Plan'is available:on-the_jobsite as requim(Lby-Titie 8.___. <br /> 3. Detailed description of work to be completed. List components to be repaired or replaced and attach a diagram <br /> drawn to scale showing locationofrepairs-and/or replacements. If repairing a component, describe how this will <br /> be done. (If_ad i _piping UDC's, or__stther-LIST_equipment,.or performing-lank top upgrade, use the UST <br /> Installation Application pages 4ti as necessary for a timely plan review): <br /> MN( -&k&At me <br /> a <br /> CpT#Z 3 aic�t Cin c <br /> i <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> 3 <br />