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C I E r <br /> UST SYSTEM RETROFIT OR REPAIR OCT V 2 2017 <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES [] N0K ENVIRONIV E g]-AL HEALI!- <br /> .2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates ore 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 B. <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 <br /> for a timely plan review): <br /> 'v'L1C9J'� 1� evls-ems �O�� <br /> Cr asp e 111Se <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showingthird-partyapproval): <br /> 3 <br />