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.':P lfii '.+, ' , ♦ I .I�«i� ,�A{ •♦.' ♦ 1• • • IIS• ,.• ..«♦a�{ ' r f <br /> i♦ V e I ♦ ♦ i+•* 1 ",\1 w 1 ♦ M f A i t A f l "X / I <br /> . 4 i ai • I 1 <br />♦ f • r - fl • ♦ • • I•r N ♦ t • 1 <br /> .f♦ <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[] 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 "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 /> adding piping, UDC's, or other UST equipment, or performing tank top upgrde, use the UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): , <br /> #fie l e b no 5CS)Z�01 ILCQ icc� i n <br /> v 99 AnnoU 5kolL <br /> UW �f6� Li& � <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br />