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UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by END) <br /> 1. Site map enclosed? YES [I NO [] <br /> 2. Submit copies ef ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for each <br /> person installin 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 showi g location of repairs and/or replacements. If repairing a component, describe haw this will be done. (if <br /> adding piping, DC's, or other UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as n cessary for a timely plan review): <br /> VPH COMML nication tubing has been installed at all fill & STP sumps for testing. RE " EIV <br /> U_ <br /> PLC o 5 2WE <br /> SNDU ENS/RONNIENTAL HEALTH <br /> - DEP A .T <br /> tJ16 <br /> 04Z. <br /> S90 <br /> a . <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> Shell - Stockton <br /> 7700 Moreland Ct <br /> Stockton, CA 95212 <br /> 2 <br />