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,Oct 1_2 09 09:58a Elite IV Contactors 120941311334.2 p.2 <br />P <br />iL <br />dle• hI& 7v 9,Fif <br />USTSYSTEWRETROFf- ORREFAIR <br />X06/ c�'� <br />(Submit minimum of -3 sets of plans'*& applications as originals will be retained by EHD) <br />Site map enclosed? YES[]' NO.[ <br />.2. Submit copies.of ICC Service Technician and/or Installes certificate and all manufacturer training certificates for each <br />Safety <br />drit th't is repaired or replaced. Erisidre a copy of the "Site Health and S <br />person installing or tesUng any compon a <br />Plan is availabl6 on the jobsite as required by Title 8. <br />3. Detailed description of work to, be :completed. fist 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 ba.don&. (if <br />.addinct.pipingi UDC's, or. other UST r. p <br />equipment,. or tank* top .Upgrqde use the UST Installation Application <br />ry for a timely 01a, n re+�W).- <br />pages 4 8 as necessary <br />Fecitication sr�c�ts owing third -party a�aroval): <br />