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U ':Sl(STrM RF'TROFIT OR., REPAIR <br />(Subm(t minimum of 3 sets of plans tl< applications as originals will be' retained by EHD). <br />1. Site ma encled? YES N0 [os <br />... .. C l <br />�(tl'_4� �� SeNice Technician andLor Installer's certiflcate,and all msnufacYursritflplC�gn&Q1 flflCsts.for eagh, <br />• <br />-person •Instsllin� or.testin any component that Is repaired or replaced. Ensure a copy of the "Site Health and. Safety <br />–�. _ <br />an.. ave a e:on o s t6as.requrd ' <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:dona; '(If . <br />Adding piping, UDC's, or other UST,e(juipment,or p©rforrriing tank top, upgrade, use the,- UST Installation Application <br />-pages 4-8 as necessary for a timely plan review): <br />• - •.n;�hvi�w ,. <br />P ..., ? �.. -p rtY ep <br />4. List of equipment to be used (At(ach matiU c�urer's s ediflcatlon sheets showing third a proval): <br />J ' <br />Ai---- tnt s fPr1t�11P <br />a <br />_..._...... .... <br />.- -- – — <br />_._77 <br />nl.tl.". � � I � ..�- �. � .�.! k ( �,�� �`a f Y �',.1+ � 4 p.6 {A.. A f � � '1 t_.t 1 1 t. J. } ,r / ' • ��1 "+,- ; ' <br />r INC.; <br />x + " <br />1 .__.. ....�.- _.....•..:,, ....,; ,.. +tl+.,+1 4' 1 11� N.I <br />._ <br />....... .. ,., <br />