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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 M 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 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 />Installing Bravo UDC adaptor frames install four (4)Dresser Wayne <br />Ovation Dispensers (two 3+0, two 3+/),and install EVR Phase II Balance <br />system with Incon ISD. Cold start required for ISD mapping <br />We will replace the failed 91 direct bury spill container. <br />lace 91 MLLD leak detector. <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />Bravo Adaptor Frames, Dresser Wayne Ovation Dispensers, OPW double <br />jpoj2net emerZency valve_. Tn on TSD cyst .m for iise with P i stingy Hirt <br />burner, Veeder-Root RS 232 Module. OPW 2100 Spill Container. <br />VMI MLLD leak detector. <br />3 <br />