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UST SYSTEM RETROFITOR REPAIR dCB eTATECONTRACTORS LICENSE BOARD
<br /> (Submit minimum of 3 seta of plane 6 applications Be originals will be retained by EHD) 80 ACTIVE LICENSE
<br /> _.804431
<br /> t. Site map—108M?-108M? VES I$ NO[] ,_CORP
<br /> •.,JONESA;OVEY GROUP
<br /> 2. Submit copies of ICC SeMce Technician and/or Imreller's-mr-te and all manufacturer veining cenekales for each INCORPORATED
<br /> person installing or testing say—,,onam that Is repaired or replaced.Ensure a copy of the'Site Heats and Safety
<br /> Plan'Is available on the)obeile as required by THIS B. ..,.A 0 IIA2
<br /> 3. Detailed description of work to be completed.List components to be repaired or replaced and ate ch a diagram drawn t!
<br /> to scale showing ecellon of repairs anNor replacements.N repalring a Component describe how this will tte done.(If ,-_,.^OW112021 "n..•,taco ce ga.
<br /> sddinD piping,UDC's,Cr other UST equipment or perfuming tank top upgrade,use the UST Installation Application
<br /> pages 4-8 as necessary for a limey,plan revlew):
<br /> Dispenser 13 6 24 Satellite Bravo SB989 Repairs:
<br /> Install Retro-Fit repai kits at all sump entries i ide UDC 13 a 24 satellite
<br /> UDC 13:(4)3/4 Electrical 4 Bolt-RF-07-01-U,(1)3" Product-RF-30-01-U
<br /> UOC 24(Sat): (3) 3" Product -RF-30-01-U,41) 3" Vapor-RF-30-01-U
<br /> -Dispensers to be removed to access penetrations Nith-in UDC'. 6 II
<br /> reinstall dispenser after completion."
<br /> 4. list of equipment to be used(ANedt menueclurafs specification sheets showing third-pady approval):
<br /> Bravo Retro Fit Sump Entry Repair Kits:
<br /> I A
<br /> Rt
<br /> UDC 13:(4)3/4 Electrical 4 Bolt -RF-07-01-0,(1)3" Product -RF-30-01 �Etls.- u
<br /> ppFED
<br /> UDC 244Sat): (3) 3" Product -RF-30-O1-U,(1.) 3"Vapor-RF-30-01-U
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<br /> ENVI RoNNENTAL HEALTH
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<br /> JONEC-2
<br /> CERTIFICATE OF LIABILITY INSURANCE °" „ 10
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<br /> THIS C—FICAT!18 ISSUED AS A MATTER OF INFOR ON ONLY AND CONFEp NO a—UPON TXA CE—MAT!HOLDER.THIS
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