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UST SYSTEM RETROFIT OR REPAIR DECEIVE <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by EHD)MAR 18 2015 <br /> 1. Site map enclosed? YES` ' No ENVIRONMENTAL, <br /> r�Co2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer traininlYWIficates for eachT <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 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 /> uV,>� $7 s�co.,�oARY fAlLurtFSy �- '/ � s/6 <br /> /. 9)340. ,24—, kfIfTff/ !filter^1z4 . <br /> 2 ILd""p✓k Oi x,3eo-s A"I SET '43 n[ <br /> 3' g)- Pr�eD✓cT 5�'t!i„i44/iY LIrL fA/L.r! �..SY�s« GiSPb S.�n-� <br /> A'> s-sr4« ) sar ylsr 6eoT ! os� sd� s/b <br /> Y- UDG M �/L NYGno ST,q T+G f4jt,.f <br /> A) T-sT44_L (;V) SnA✓a fL2 kt-r-o aT ea.ALL pnaDv�7 /..t w UDe %Z <br /> 05) Im 5ALL 0 F26 Me rV Fir arm !/*Pati jl .f /..✓ UIDe %Z <br /> c� S-srsv� C3) 6Re✓� Fo7 /.gT�e f,T :,. AaL «o�,Ts , , UW_ '/a <br /> r <br /> /L$ <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> t 156L 2,7x7.74 -Vtit LfPAr.- r65-1 keT6 z/ OW <br /> Z ' 4 <br /> 63/1 Ave (L.)c -Z.sxZ.S - /lF-wF;r -s eno ,,er ct, ,E <br /> 3 6^4vo F-2e - 1,1-rna f.T <br /> y - 3 eg1z,4va f-07- NT^6 f, r -5 Cry v0✓i <br /> ,I-oTf : 611 rf0--4C OeLo-s Fon ev-r S/W1 S <br /> 3 <br />