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OUST SYSTEM RETROFIT OR R IR <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by EHD) <br /> 1. Site map enclosed? <br /> YES[I . NO <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer <br /> person installing or testing any component that is repaired or replaced. Ensure a copy of the°Site Health <br /> ' .Plan"is available on the jobsife as. framing certificates for each <br /> -- - required-by Ttie,-8: _ _ and-Safety <br /> 3. Detailed description of work to be completed List components to be repaired or replaced_and attach a diagram d <br /> to scale showing nU location of repairs-and/or replacements --1f Malting a component,describe how this will be done: (If <br /> addin 9 raven <br /> a piping, UDC's, or other UST equipment or perforrriing tank top upgrade, use the UST Installation Application . <br /> Pages 4-8 as necessary for a timely plan review): <br /> 7 <br /> NK <br /> { <br /> - A <br /> AMP <br /> 4. List of.equipment to be used(Attach manufacturer's specification sheets showing third-pa approval). <br /> dY.. <br /> 1 ® I <br /> t <br /> 3 <br />