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8��0 <br /> �� <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum cf 3sets ofplans&applications aeoriginals will beretained byEHO) <br /> 1. Site map enclosed? YEGCj NO[] <br /> 2. Submit copies ufICC Service Technician and/or Installer's certificate and all manufacturer training oertifioatesfor each <br /> person installing ortesting any component that imrepaired orreplaced. Ensure acopy ofthe "Site Health and Safety <br /> Plan"ioavailable onthe jobsitemyrequired byTitle 8. <br /> 3. Detailed description nfwork 0obecompleted. List components toberepaired o,replaced and attach adiagram drawn <br /> bzscale showing location ofrepairs and/or replacements. |frepairing ocompnnantdenohbehow this wiUbedone (|f <br /> L���Lpiping. UDC's, orother UST equipment, or performing use the LIST Installation Application <br /> pages 4'8manecessary for atimely plan reviuw): <br /> ikp for-like <br /> 4. List of equipment to be used(Attach manufacturer's specification sheets showing third-party approval): <br /> VR N\DMEM Board - 332966-203 and ODVV New Style Spill Container. <br />