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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 [3 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 />Fla_ -d with like-fny—like arruipmAnt, the float and chain kit in <br />Disp #1/2 UDC, and the annular sensor in both UST #1 and #2/3 during <br />the MSC performed on 05/17/12. <br />Replace with like -for -like OPW direct bury 89 spill bucket. Inspection <br />prior to backfill and concrete. <br />Re -test and provide reports to CUPA and Owner. <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />OPW 2100 Series spill container <br />Veeder-Root 420 annular sensor <br />Bravo Float Assembly FA -FLOAT <br />0a <br />