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I <br /> a <br /> i <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 N NO [ ] <br /> 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 /> addingpiping , 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 /> T- 1 - Diesel — Replace FFS Phil -Tite overfill prevention drop tube PN : 70859 <br /> T- 6 - Autodiesel — Replace FFS Phil -Tite overfill prevention drop tube PN : 70859 <br /> T- 8 - Biodiesel - Replace OPW overfill prevention drop tube PN : 71 SO-420CT <br /> T4 - 87 - Replace FFS Phil -Tite overfill prevention drop tube PN : 70859 - <br /> T- 5 - 91 - Replace FFS Phil -Tite overfill prevention drop tube PN : 70859 <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval ) : <br /> (4) Franklin Fueling PhikTite overfill prevention drop tube PN : 70859 <br /> ( 1 ) OPW overfill prevention drop tube PN : 71 S0 420CT <br /> EH230038 (revised 7-26-2016) 3 <br />