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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 Pq NO [ I <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 />Remove and set aside for sale or disposal dispenser #'s 3/4 and 7/8. Remove and set aside for re -installation dispensers #'s 1/2 and 5/6. <br />_ i I ,� .1 <br />Excavate between western most UST and dispensers 3/4 and 7/8. Install UST components to convert current 87 siphon tank to diesel UST. <br />Install new Smith FRP 3" over 2" product line to new dispensers. Install new Bravo B8000 UDCs at dispensers 3/4 and 7/8. Demo and <br />replace damaged concrete at islands 3/4 & 7/8. Install sensors and electrical to UST sumps and UDC's per CUPA. Install new <br />Encore 700 3+1 dispensers for 3/4 and 7/8 to include Diesel. Program, commission, set up POS and calibrate new dispensers. <br />4. List of equipment to be used CA-tttach manufacturer's s <br />Smith FRP 3" over 2" product line p/ <br />0) -Bravo B8000 UDC, g CJU D <br />Gilbarco Encore 700 3+1 Dispenser <br />-f &Q,j '4­1i',e'1't'4A <br />-44 <br />1 <br />fication sheets showing third -party approval): (J- <br />j c_ w <br />�fi rip/ , �,;; � ►�� � ( h �y <br />I <br />� wL <br />,kms►5,, <br />U 'Yf � 7y1.iYrf r'�j✓ C/Y D <br />o <br />.,r�� <br />er � � <br />EH230038 (revised 7-26-2016) 3 <br />