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UST SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans& applications as originals will be retained by EHD) <br />t!o <br />I . Site map enclosed? YES [ j` NO [I <br />2. Submit copies of 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 showing location of repairs and/or replacements. If repairing a component, describe how this will be done. (If <br />add in piping, UDC'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 />, mnl. <br />JJJ - <br />WM IF 2 WJA W,JrLWE <br />f <br />M off <br />1 <br />2. . <br />