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Mar 19 13 12:23p Reliable PetroleurnA 209-845-8953 p.31 <br />UST SYSTEM RETROFIT OR REPAIR <br />(Su )mit minimum of 3 sets Of Plans & applications as originals will be retained by EHD) <br />1. Site map enck)sa YES NO <br />2. Submit copies of '_C service Technician and/or inst'aller's certificate and all manufacturer training certifi6ates 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 descriptid n of work to be completed. List components to be repaired d and attach a diag I ram drawn <br />to scale showing 1: cation of repairs and/or replacements.Pa or replaced <br />addingnt, or performing If repairing a component, describe how this will be done. (ff <br />. piping, UD I 'I's, or other LIST equipme tank top upgrade, use the UST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />E <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />6 <br />3 <br />