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UST SYSTEM RET II'�OF T OR RCEPAiR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHD) <br />1. Site map enclosed? YES [ j NO [ ] <br />2. Submit copies of ICC Service-Technician_and/or installer's certificate. and- all. manufacturer training certificates for <br />each person installing or-testingarty--component-that is repaired or -replaced- Ensure a copy of the "Site 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 />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />a I L ,2I CCI7 L �' 1(r'� <br />3 <br />a <br />U 6111-1 <br />`,)Cly <br />r) Ald, �i <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />a I L ,2I CCI7 L �' 1(r'� <br />3 <br />a <br />