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Jul 22 09 10:18a J.R. Beard <br />805-540-5241 p.3 <br />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 W 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 "Si 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 a d attach a diagram drawn <br />to scale showing location of repairs and(or replacements. If repairing a component, descr a how this will be done. (If <br />adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use t UST <br />Installation Appl�ation <br />pages 4-8 as necessary for a timely plan review): <br />PLEASE SEE DEMOLITION NOTES ON SHEET CI -1 AND INSTALLATION N ES ON SHEET C2-1 <br />FOR DESCRIPTION OF WORK <br />r <br />n� <br />4. List of equipment to be used (Attach manufacture speclficatlon sheets showing third -party approval): <br />PLEASE SEE ATTACHED EQUIPMENT LIST ON SHEET C3-1 AND CUT SHEETS <br />F <br />0 <br />a <br />2 <br />