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JUL 16 2012 <br /> UST SYSTEM RETROFIT OR REPAIR ;, JWTfy <br /> (Submit minimum of 3 sets of plans&applications as originals will be retained by HD} <br /> 1. Site map enclosed? YESX NO[] <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 UST equipment, or performing tank top upgrade, use the UST Installation Application <br /> pages 4-8 as necessary for a timely plan review): <br /> 9 Ce all 5i 0AW 546J + sawlsi stril rekrOoZmL <br /> I-21dyn 1n 9041—YWAk (SMW arli, ge-6y, it 69F1L <br /> b—Adro) 1W It— 21 on 'j, <br /> ec�ari l DID Ills 11 IN) w'" <br /> nSi C/1 <br /> ot11~si can bol 1 Zvi N lei}k et' rare BIJ:2-R -ZAA <br /> Q6 low Point, <br /> WWI fro GJ) A�Ijbh Wto-5 i r` (F) LOSE. <br /> 1�Lnl�s on r r oil Q = X94 ^6t�lf �ori(�Ii end ern, <br /> v ° 4r4r_ one eii bcs- WOle on &4. coat qeA 664" 1004ors <br /> 1^S0 e gtwaaa ofinla in 0et areas. 14 it bio W 1 k Sensors JR W."00-14) <br /> otn lam' �I rs ark �a +n . 1rs6� ��ca1;e ST t�n� � �ha� <br /> VGlt� 'S m Le4o,- <br /> tN� 6:'j- fro <br /> 4. List of equipment be used(Attach manufacturers fication sheets showing third-party approval): <br /> r 4 leak -. -49438 ZOW C 3 IL' <br /> ti <br /> '49434o-42o <br /> anh 40 bbcic. 14 <br /> rd 0111t/cLn-mar sapplq a <br /> P - go a in tsm; 1'�4 <br /> Enffg�Evf' ri af8s. FIC. 2-44 <br /> I� -- r Sia l : rnlirinK ro6cs ;or 2, base � k3 o-, <br /> ("ooh lsezpe cg weir k. 3a tm ks arc ino sha I(mJ <br /> 6 accd dapro6e inswlati6e, . - <br /> 2 <br />