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UST SYSTEM RETROFIT OR REPAIR <br /> ( ubmit minimum of 3 sets of plans& applications as originals will be retained by EHD) <br /> 1. Site map enclo ed? YES[] NO [] <br /> 2. Submit copies f 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 showi g location of repairs and/or replacements. If repairing a component, describe how 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 necessary for a timely plan review): <br /> VPH Communication tubing has been installed at all fill & STP sumps for testing. RECEIVEU <br /> P4 0 5 2W <br /> ENVIRONMENTAL HEALTH <br /> SND AQP ---QEP^ �T <br /> z 12 <br /> r m 6 ... <br /> _5 <br /> S90 <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 />