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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will'be retained by EFID) <br />I Site map nclosed? YES [I NO <br />2. Submit copies of ICC Service.Techrild.an 6nd/or-In.stalle.(s certificate and all manufacturer.training certificate.s.foreaph . <br />person on installing or testing any component that Is repaired or replaced. Ensure a copy of the ",Site Health and Safety <br />Plan", ls..avallable. 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 />4. List of equipment to be used (Attach manufacturers specification sheets showing third -party approval): <br />Cro tat mBrit- \J(k- I �-f rya y.4 <br />- - ---------- -- --- -- <br />I <br />1 1, 4 4 4 <br />11 <br />4 <br />A t $4 9 4 <br />