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11 T Sys, RETROFIT R: -P t <br /> (Submit minimum of 3 sets of plans&appiicaftons as originals will>be retained by EHD): <br /> 1. Site map enclosed? YES[] NO:O <br /> 2: Submit copies of-{GC enneg4echniclon and/or installer's certifcate a►ad all manufaoturer�tralp[ng ce! fipates far epota, . _ <br /> personinstalling or testing any component that is repaired or replacedd Ensure a'copy of the;".Site;Health and Safety <br /> Plan'.'.is..avallableon the.)obsite..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-cpairs and/or replacements. If repairing a component,describe how this will be,done: (If . <br /> pdding piping,UDCs, or W e[r UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as necessary for z timely plan review): <br /> .. illfo <br /> ® .fit <br /> rou 1 1141r �e rep�i <br /> I <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing`third-party approval): <br /> a <br /> RA,ice,m <br /> l <br /> f d..:R 6 • s F i � <br /> q <br /> f f <br /> ef..a�.F #.,Ax. ..tlt e " e-a ax :,f Sip}- stx,ia'.#e tpel.fK. a a: 4 t8 •e,°4 ::;n .,,:.r. .. .. ;�`5t,^ '.'{r':atf_�#t.' <br />