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r <br /> d , - rY <br /> 1210 E Hammer Ln Stockton Ca SR#0081167 Correction to amend permit 3!12/2020 , <br /> E <br /> A <br /> ( Environmental Health Dep l i�t" <br /> � � o [I <br /> __ . COUNTY ---- ., tt <br /> UST SYSTEM RETROFIT OR REPAIR S � TAL [ ;" <br /> (Submit minimum of 3 sets of plans & applications as originals will be retained by EHDj <br /> 1 . Site map enclosed ? YES [ ] NO [ ] <br /> 2 . Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training <br /> certificates for each person installing or testing any component that is repaired or replaced . Ensure a copy of <br /> the " Site Health and Safety 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 <br /> diagram drawn to scale showing location of repairs and/or replacements . If repairing a component, describe <br /> how this will be done . ( If adding piping , UDC's , or other UST equipment, or performing tank top upgrade, <br /> use the UST Installation Application pages 4-8 as necessary for a timely plan review) : <br /> Replace 87 / 91 / diesel spill containers in existing sump. <br /> Replace 87 191 / diesel drop tubes with overfill prevention <br /> 4 . List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval) : <br /> 3) Phil-Tate 85100-1 replacement 5 gallon bucket <br /> 3) EBW 708592902 Defender Overfill Prevention Drop Tube <br /> 5 . Decontamination Procedures : <br /> a . Will piping be decontaminated prior to removal? YES [ J NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name Phone {�) <br /> Address City Zip <br /> 3 of 6 <br />