Laserfiche WebLink
SAN 10 A Q U I N Environmental Health Department <br /> COUNTY <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 [v( 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 , LIDC ' 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 /> For existing fuel dispensers/ udc' s 7/8 & 9/ 10 - Remove existing conduits , patch existing <br /> electrical penetration within the existing fiberglass udc . Install 2 new , 3/a°' penetration fittings . <br /> Conduct an SB989 test . <br /> 4 , List of equipment to be used (Attach manufacturer's specification sheets showing third - party approval ) : <br /> Bravo Penetration Fitting F - 07 - FF - RR <br /> 5 , Decontamination Procedures : <br /> a , Will piping be decontaminated prior to removal ? YES [ ] NO [ ] <br /> b . Identify contractor performing decontamination : <br /> Name N /A Phone ( ) <br /> Address City Zip <br /> 3of6 <br />