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w IL:�4LowLz- <br />UST SYSTEM RETROFIT OR REPAIR IUL 2 9 2016 <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EHd) <br />1, Site map enclosed? YESO NO [2] <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 />adding piping, UDC's, or other LIST equipment, or performing tank top upgrade, use the LIST Installation Application <br />pages 4-8 as necessary for a timely plan review): <br />replaced turbine relay on tank #3 (91) <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />Red Jacket 079-425-1 <br />2 <br />