Laserfiche WebLink
1 <br /> UST SYSTEM RETROFIT OR REPAIR <br /> (Submit minimum of 3 sets of plans &applications as originals will be retained by EHD) <br /> 1. Site map enclosed? YES [] NO <br /> 2. Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates for <br /> each person installing or testing any component that is repaired or replaced. Ensure a copy of the "Site Health <br /> and Safety 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 <br /> drawn to scale showing location of repairs and/or replacements. If repairing a component, describe how this will <br /> be done. (If adding piping, UDC's, or other UST equipment, or performing tank top upgrade, use the UST <br /> Installation Application pages 4-8 as necessary for a timely plan review): <br /> 4 ) //�1Co tJ r O b/ Ti44\3K Cry oN i M 2 u--)R S hlo T `JCS o <br /> TEs TZ Lr <br /> Tu EZC��� �s -- � adv(C-ac� �'T c►,1 (�,-S (��r Pfi� <br /> Tc) ��PAt�.S ��sZ- t'�rloc�cc�Czcn1� <br /> E Q�,_\l PonEA-4V Tco <br /> 4. List of equipment to be used (Attach manufacturer's specification sheets showing third-party approval): <br /> C`At,( I (Do 1 PR4 GZPK-n m (N G ot-f(_V <br /> T�STl� G Tho © ��C' .m ca�f cz <br /> �r�Kc�o�St�l e - T14--I S T(nn <br /> 3 <br />