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Jan 13 11 12: 43p Elite -V Contactors 120946'-342 p. 1 <br /> �r 7/d <br /> UST SYSTEM 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[] NO(] JAN 13 2011 <br /> _. , _ . <br /> 2. Submit copies of ICC Service Techaan and/or Installers certificate and-all manufacturer training certifieetesft>,F; <br /> eachperson installing or testing any component that is repaired.or replaced. Ensure a copy of t!I Health <br /> and Safety 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 <br /> drawn to scale showing location of repairs and/or replacements. If repairing a component, describe how this will <br /> be done. (If adding 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 review): <br /> k� <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> 3 <br />