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T- SYSTEM RETROFIT OR REPAIR <br />(Submit minimum of 3 sets of plans & applications as originals will be retained by EMD) <br />1. Site map enclosed? YES [ ] NO [ l <br />2; Submit copies of ICC Service Technician and/or Installer's certificate and all manufacturer training certificates foreach <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 />CL CX*10 <br />nm c r'5 ah lei r&rf <br />Aida <br />--h+Wrjhd _LW LSl <br />W. <br />t <br />r r <br />4. List of equipment to be used (Attach manufacturer's specification sheets showing third -party approval): <br />3 <br />